With its unparalleled expertise in Retrograde Intra-Renal Surgery (RIRS), Meenakshi Mission Hospital and Research Centre successfully cleared two large kidney stones in a 62-year-old female patient who was on dual antiplatelet therapy.
RIRS, a minimally invasive procedure for treating kidney stones, is typically used to remove stones up to 2 cm in size. However, performing this procedure to remove larger stones, especially in patients taking antiplatelet medications to prevent blood clots, requires advanced facilities and high levels of expertise.
In this patient, who had cardiac stenting just a month ago, the right kidney stone measured 3.5 x 2.5 cm and the left kidney stone measured 2 x 1.5 cm. Both stones were completely cleared, and the patient is doing well post-surgery.
At present, Meenakshi Mission is the only hospital in the city using RIRS to remove large kidney stones in patients who are on antiplatelets or anticoagulants, as well as those with liver diseases and anatomically abnormal kidneys groups typically considered high-risk and often deemed unfit for any treatment. Additionally, it is one of the few hospitals in the country to boast a success rate of 90% and above in RIRS procedures.
In his comments, Dr. D. Paul Vincent, Senior Consultant Urologist, Andrologist, and Robotic Surgeon at Meenakshi Mission Hospital and Research Centre, who led the procedure, said, “RIRS involves passing a flexible ureteroscope—a thin, tube-like instrument equipped with a camera and light—through the urethra, bladder, and ureter into the kidney. A laser is then used to break the stone into tiny fragments, which are either removed with a basket or allowed to pass naturally through the urine. While RIRS is typically used for stones up to 2 cm in size. However, with expertise, it can also be performed for larger stones in a staged manner. A high level of expertise is required, especially when treating patients with heart or stroke conditions who are on blood thinners, those with liver failure, anomalous kidneys, or bleeding disorders involving coagulation issues.”
He said that the benefits of RIRS include the fact that there is no incision at all, resulting in a lower chance of bleeding and minimal complications. Patients can usually be discharged the next day and return to work early, making it a convenient and less invasive treatment option.
Talking about the risks and preventive steps for kidney stones, Dr. Paul explained that these stones form when certain substances in the urine become too concentrated, leading to the formation of crystals that gradually grow into hard stones. Common symptoms include loin pain, a burning sensation during urination (burning micturition), and blood in the urine. As preventive measures, he recommended drinking at least 3 liters of fluids daily to maintain a urine output of 2 liters per day, and reducing the intake of non-vegetarian food.
Dr. R. Ravichandran, Senior Consultant and HOD - Urology, Dr. D. Paul Vincent, Senior Consultant Urologist, Andrologist, and Robotic Surgeon, Dr. K.Venugopal Konanki, Senior Consultant - Urology and Mr. Sivakumar, General Manager – Marketing were also present during the press meet.