# Endoscopic combined intrarenal surgery for successful removal of an encrusted ureteral stent and multiple renal stones in solitary kidney: A case report

## TL;DR

This case report describes the successful use of a combined endoscopic technique to remove a neglected stent and multiple kidney stones in a patient with only one kidney.

## Contribution

The paper presents a case where ECIRS was used to manage complex kidney stones and an encrusted stent in a solitary kidney.

## Key findings

- ECIRS successfully removed a neglected DJ stent and multiple stones in a solitary kidney.
- The patient was discharged with no complications and no residual stones.
- ECIRS offers a safe and effective approach for complex nephrolithiasis cases.

## Abstract

Several endoscopic procedures have been performed to clear stones in the kidney. A potential technique called endoscopic combined intrarenal surgery (ECIRS) is a practical option for treating complex kidney stones. Hereby, we report a neglected double j (DJ) stent and recurrent multiple kidney stones treated by ECIRS.

A 56-year-old female complained of right flank pain one week ago, which worsened within one day before hospital admission. She underwent DJ stent insertion one year ago because of residual stones after right percutaneous nephrolitothomy (PCNL) but was lost to follow-up. There was a history of left nephrectomy, leaving the patient with only a right kidney. A x-ray kidney ureter bladder (KUB) evaluation showed multiple irregular radiopaque shadows. A computed tomography (CT) scan detected numerous stones in the right kidney. The patient underwent ECIRS to remove the DJ stent and clear multiple stones in the right kidney. Following the surgery, the patient was discharged from the hospital on the fourth postoperative day with no complications and residual stone.

ECIRS is a technique that combines a simultaneous antero-retrograde approach to the kidney and aims to resolve nephrolithiasis in one step and with one access. The ECIRS procedure could be considered in cases of complex multiple stone nephrolithiasis. ECIRS could widen the operative vision, thus helping to clear difficult kidney stones.

The ECIRS technique could provide successful and safe management of recurrent multiple kidney stones and encrusted, neglected DJ stents in a solitary kidney patient.

•Endoscopic Combined Intra Renal Surgery (ECIRS) is a practical option for treating complex kidney stones.•ECIRS is a technique that combines a simultaneous Antero-retrograde approach to the kidney•ECIRS achieves high stone-free rates with low complication rates•The ECIRS technique could provide successful and safe management

Endoscopic Combined Intra Renal Surgery (ECIRS) is a practical option for treating complex kidney stones.

ECIRS is a technique that combines a simultaneous Antero-retrograde approach to the kidney

ECIRS achieves high stone-free rates with low complication rates

The ECIRS technique could provide successful and safe management