Pain After RIRS Surgery: What Is Normal?
Pain after RIRS surgery is common for a few days. Side pain, burning while passing urine, frequent urination, bladder discomfort and mild blood in urine can happen, especially if a DJ stent is placed. This usually improves with rest, fluids and prescribed medicines. But severe pain, fever, chills, vomiting, inability to pass urine, heavy bleeding or clots are not normal. These symptoms may suggest infection, blockage or another complication and need urgent medical care.
What is RIRS surgery?
RIRS means retrograde intrarenal surgery. It is a minimally invasive kidney stone surgery done using a thin flexible camera passed through the urinary passage, bladder and ureter into the kidney. The stone is usually broken with laser energy.
RIRS does not involve a cut on the back like PCNL. But the kidney and ureter are still handled from inside, so some pain, burning and blood in urine can happen during recovery.
A temporary DJ stent may be placed after RIRS. This soft tube keeps the ureter open, helps urine flow from the kidney to the bladder and supports healing if the ureter was irritated during surgery. The stent is removed later as advised by your urologist.
Pain after RIRS surgery: what is normal?
Pain after RIRS surgery is usually expected if it is mild to moderate, controlled with medicines and gradually improving.
| Symptom | Why it may happen | Usually normal if… |
|---|---|---|
| Side or back pain | Kidney, ureter or stent irritation | It is improving |
| Pain while passing urine | Stent-related pressure or bladder spasm | It is brief and manageable |
| Burning urine | Urinary passage irritation | It reduces over a few days |
| Frequent urination | DJ stent touching the bladder | No fever or urine blockage |
| Urgency | Bladder irritation | Manageable |
| Pink or red urine | Healing inside the urinary tract | Mild and intermittent |
| Tiredness | Anaesthesia and recovery | Improving with rest |
Ureteral stents can cause burning, lower back pain while passing urine, blood in urine, urgency and frequent urination. These symptoms are common, but they should not be severe or worsening.
How much pain is acceptable after RIRS?
A pain score can help you judge your recovery, but it does not replace medical advice.
| Pain score | What it means | What to do |
|---|---|---|
| 0-3/10 | Mild discomfort | Usually expected |
| 4-6/10 | Moderate pain | Take prescribed medicines and monitor |
| 7-10/10 | Severe pain | Contact your urologist |
| Pain with fever or chills | Warning sign | Seek urgent care |
| Pain with inability to pass urine | Warning sign | Seek urgent care |
The key rule is simple: pain should trend down, not up. Pain that becomes worse day by day needs review.
Day-wise recovery after RIRS
| Time after RIRS | What many patients feel |
|---|---|
| First 24-48 hours | Side pain, burning urine, mild bleeding, tiredness |
| Days 3-7 | Pain and burning usually start reducing |
| While DJ stent is inside | Frequency, urgency, side pain during urination, blood-tinged urine |
| After stent removal | Mild cramps or burning may happen briefly, then settle |
Recovery depends on stone size, infection before surgery, operative time, ureteric swelling, stent placement, kidney function, diabetes and the amount of stone dust left behind.
Why does pain increase while passing urine after RIRS?
Many patients feel a sharp pull, cramp or kidney-side pain while passing urine after RIRS. This is often due to the DJ stent.
During urination, pressure from the bladder can travel upwards along the stent towards the kidney. This may cause temporary flank pain on the operated side. This is usually not dangerous if it is brief and not associated with fever, vomiting, heavy bleeding or inability to pass urine.
What can make pain worse after RIRS?
Pain may increase because of DJ stent irritation, less water intake, excess walking too early, long travel, bumpy two-wheeler rides, passing small stone fragments, urinary infection, ureteric swelling, blood clots or temporary blockage of urine flow.
Avoid taking leftover antibiotics or strong painkillers without asking your doctor. Some medicines may be unsafe if you have kidney disease, acidity, blood thinners, uncontrolled BP, diabetes or heart disease.
What should you do today?
Usually okay to monitor at home
You can usually monitor symptoms at home if pain is mild, urine is only lightly blood-stained, you can pass urine, there is no fever and symptoms are gradually improving.
Call your urologist today
Call your urologist if pain is not improving, burning is increasing, urine is becoming darker red, stent symptoms are disturbing sleep or work, or you are unsure about your stent removal date.
Go to emergency care
Go to emergency care if you have fever, chills, severe side pain, vomiting, inability to pass urine, heavy bleeding, clots, reduced urine output, dizziness or sudden worsening after initial improvement. BAUS patient guidance advises urgent contact after ureteroscopy if there is fever, kidney-area pain, severe pain while passing urine, inability to pass urine or worsening bleeding.
What can you do at home for normal pain?
Drink enough water as advised by your doctor. Do not force excessive water intake if you have heart disease, kidney disease or fluid restriction.
Take medicines exactly as prescribed. Your urologist may prescribe painkillers, antibiotics, urinary relaxants or bladder spasm medicines depending on your case.
Avoid heavy lifting, gym workouts, running, cycling, long two-wheeler rides and strenuous travel until your doctor allows.
Rest if urine becomes red after activity.
Do not pull or remove a DJ stent unless your doctor has specifically instructed you.
Do not miss your stent removal date. A forgotten DJ stent can lead to infection, stone formation over the stent and kidney damage.
Can I work, travel or exercise after RIRS?
Many patients can return to desk work within a few days if pain is controlled, bleeding is mild and there is no fever.
You may need more rest if your work involves heavy lifting, long standing, field visits, long travel, two-wheeler riding or poor toilet access.
Light walking is usually acceptable for many patients. Avoid weight training, running, cycling, heavy abdominal exercises, contact sports and long bike rides until your urologist clears you.
If activity increases blood in urine or flank pain, reduce activity and speak to your urologist if symptoms continue.
Why follow-up matters after RIRS
Follow-up after RIRS helps your urologist check whether pain is settling, infection is absent, the kidney is draining well, stone fragments are clearing and the DJ stent can be removed safely.
NICE guidance on renal and ureteric stones focuses on improving stone detection, clearance and prevention, while reducing pain, anxiety and quality-of-life impact from stone disease.
What to bring for consultation
- Discharge summary
- Operative notes, if available
- CT KUB or USG before surgery
- X-ray KUB, USG or CT after surgery, if done
- Urine routine report
- Urine culture report
- Serum creatinine report
- List of current medicines
- DJ stent removal date
- Photos of urine colour or clots, if relevant
FAQs
Is pain after RIRS surgery normal?
Yes. Mild pain after RIRS surgery is normal for a few days. It is more common if a DJ stent is placed. The pain should gradually improve and should be controlled with prescribed medicines.
Why do I have kidney pain while passing urine after RIRS?
This is often due to the DJ stent. During urination, bladder pressure can travel upwards towards the kidney and cause temporary side pain.
How many days does pain last after RIRS?
Many patients improve within a few days. If a DJ stent is present, some pain, urgency, burning and blood in urine may continue until stent removal.
Is burning urine normal after RIRS?
Mild burning urine is common after RIRS. Severe burning with fever, chills, foul-smelling urine or worsening pain may suggest infection.
Is blood in urine normal after RIRS?
Mild blood staining can happen after RIRS, especially with a DJ stent. Heavy bleeding, clots or inability to pass urine is not normal.
When should I worry about pain after RIRS?
Worry if pain is severe, worsening, associated with fever, vomiting, clots, reduced urine output or inability to pass urine.
Can a DJ stent cause pain after RIRS?
Yes. A DJ stent can cause flank pain, bladder discomfort, frequency, urgency, burning urine and blood-tinged urine. These symptoms usually settle after stent removal.
Can I travel with pain after RIRS?
Short travel may be possible if pain is mild and there is no fever or heavy bleeding. Avoid long travel or bumpy two-wheeler rides if you have significant stent pain or blood in urine.
When is a DJ stent removed after RIRS?
Stent removal timing depends on stone size, ureteric swelling, infection risk and your surgeon’s plan. Do not delay stent removal beyond the advised date.
Related reading
- RIRS Surgery for Kidney Stone
- Diet After Kidney Stone Surgery: What to Eat, Drink and Avoid
- Burning Urination After DJ Stent: What Is Normal?
- Blood in Urine After Kidney Stone Surgery: What Is Normal?
- Exercise After Kidney Stone Surgery: Walking, Gym, Running and Lifting Timeline
- Kidney Stone Doctor in Latur