Kidney & ureteric stones: symptoms, procedures & recovery explained.
A practical guide to urinary stones — when they need treatment, and how modern keyhole procedures (URSL, RIRS and MiniPCNL) remove them safely.
Common symptoms of stones.
- Severe pain in the side or back, below the ribs
- Waves of pain travelling from the loin to the groin
- Pink, red or brown urine (blood in urine)
- Nausea or vomiting during pain episodes
- Frequent urge to pass urine, or burning while passing urine
Emergency: fever or chills along with stone pain can mean infection behind a blocked kidney. This needs immediate medical attention — do not wait.
How stones are diagnosed.
- Ultrasound — a quick first look at the kidney and bladder, and any swelling from blockage
- CT scan — the most accurate test; shows the exact size and position of the stone, which decides the treatment
- Urine and blood tests — check for infection, kidney function and stone-forming tendency
- Stone analysis — if a stone is passed or removed, analysing it helps prevent the next one
Treatment options — from medical management to keyhole procedures.
- Medical management — small stones (often up to about 5 mm) may pass on their own with hydration, pain relief and medicines that relax the ureter.
- URSL (ureteroscopic lithotripsy) — a thin scope is passed naturally through the urethra to the ureter, and the stone is broken with a pneumatic lithotripter or laser.
- RIRS (retrograde intrarenal surgery) — a flexible scope bends into the kidney to laser stones inside the kidney, with no cuts at all.
- MiniPCNL (mini percutaneous nephrolithotomy) — for large stones, a very small keyhole in the back allows the stone to be broken and removed directly from the kidney.
Dr. Sreeniketh Reddy performs advanced URSL, RIRS and MiniPCNL techniques for safe, effective stone removal at MEDICOVER Hospitals, Hitec City.
URSL, RIRS and MiniPCNL — what each one is.
What is URSL?
Ureteroscopic lithotripsy (URSL) uses a thin, rigid telescope passed through the urethra and bladder into the ureter. The stone is then broken with a pneumatic lithotripter or laser, and the pieces are removed or pass naturally. It is the standard procedure for stones stuck in the ureter.
What is RIRS?
RIRS uses a flexible telescope that bends all the way up into the kidney itself. The laser dusts the stone into fine particles. Because everything passes through the natural urinary passage, there are no cuts — recovery is usually very quick.
What is MiniPCNL?
MiniPCNL is the keyhole operation for large or complex kidney stones (typically stones above about 2 cm). Through a very small opening in the back, a telescope enters the kidney, and the stone is broken and removed in the same sitting.
Which procedure suits which stone?
The choice depends on the stone's size, location and hardness, whether infection is present, and your kidney function — all of which your scans will show. URSL is generally used for stones in the ureter, RIRS for stones inside the kidney, and MiniPCNL for large or complex kidney stones. No single procedure is best for every stone.
About stents: after URSL, RIRS or MiniPCNL, a thin temporary internal stent is sometimes placed between the kidney and bladder to let healing happen smoothly. It can cause some frequency or mild discomfort and is removed after 1–2 weeks in a short outpatient visit.
Recovery after stone procedures.
- URSL / RIRS — most patients are discharged the next day, and return to desk work within 2–3 days.
- MiniPCNL — usually 1–2 days in hospital and about a week of lighter activity.
- Mild blood in urine or burning for a few days is common after any stone procedure and settles on its own.
- Drinking adequate water after the procedure flushes out fine fragments and helps healing.
Risks and limitations — explained honestly.
- Some fine fragments may remain and pass over the following weeks; occasionally a second sitting or an additional procedure is needed for complete clearance.
- Temporary stent-related frequency or discomfort is common when a stent is placed, until it is removed.
- Uncommon risks include infection, bleeding, or injury to the ureter — your urologist will discuss how these apply to your stone.
- Removing the stone does not stop new stones forming — prevention (below) is the other half of treatment.
How to reduce the chance of another stone.
- Drink about 2.5–3 litres of water a day — enough to keep your urine light yellow. Increase this in summer heat or if you sweat heavily.
- Moderate your salt intake — high salt increases stone-forming calcium in urine.
- Keep normal dietary calcium (do not cut out dairy without medical advice) and moderate very high-oxalate foods if advised.
- If you have had a stone, ask about a stone analysis and basic metabolic tests — they often reveal a correctable cause.
Stone care with Dr. Sreeniketh Reddy.
Consultant Urologist, Andrologist and Robotic Surgeon (M.S, M.Ch Urology; Fellowship in Advanced Laparoscopic, Robotic & Renal Transplant Surgery). His stone practice covers advanced URSL, RIRS and MiniPCNL techniques at MEDICOVER Hospitals, Hitec City and LUX Hospitals, Gachibowli — from first diagnosis to prevention of recurrence.
View full doctor profile →Frequently asked questions.
Which size kidney stone needs surgery?
Stones up to about 5 mm often pass on their own with hydration and medicines. Stones around 6–7 mm or larger, stones that are stuck, very painful, causing infection or blocking urine flow usually need a procedure such as URSL, RIRS or MiniPCNL. The decision depends on size, location and symptoms — not size alone.
What is the difference between URSL, RIRS and MiniPCNL?
URSL uses a thin rigid scope passed through the urethra to reach stones in the ureter and break them with a pneumatic lithotripter or laser. RIRS uses a flexible scope that bends into the kidney to treat stones inside the kidney. MiniPCNL is used for large stones — a very small keyhole is made in the back to remove the stone directly from the kidney. None of them involve large cuts.
Is kidney stone surgery painful?
Stone procedures are done under anaesthesia, so you feel nothing during the procedure. Afterwards there may be mild discomfort, burning while passing urine, or a temporary stent that can cause frequency for a few days. Most patients are surprised by how quick the recovery is.
How long is recovery after RIRS or URSL?
Most patients are discharged the next day after URSL or RIRS, and return to desk work within 2–3 days. A temporary internal stent is sometimes placed and removed after 1–2 weeks. MiniPCNL for larger stones usually needs 1–2 days in hospital and about a week of lighter activity.
Will my kidney stones come back?
Stones can recur, which is why prevention matters. Drinking enough water to keep urine light yellow (about 2.5–3 litres a day, more in Hyderabad's heat), moderating salt, and a stone analysis with basic metabolic tests help reduce recurrence. Your urologist will personalise this advice.
When is a kidney stone an emergency?
Fever or chills along with stone pain is an emergency — it can mean infection behind a blocked kidney and needs immediate care. The same applies if you cannot pass urine, have vomiting that prevents drinking, or pain that is not controlled by medicines.
Get your symptoms evaluated.
Request an appointment with Dr. Sreeniketh Reddy at MEDICOVER Hospitals, Hitec City or LUX Hospitals, Gachibowli. Bring any previous scans or reports if available.