# Inability to Perform Retrograde Ureteroscopic Stone Treatment: A Postoperative Anatomical Change After Fleur-de-Lis Abdominoplasty

## TL;DR

This paper discusses how a type of abdominoplasty surgery can change pelvic anatomy, making certain urinary procedures difficult.

## Contribution

The paper highlights a previously underreported anatomical change post-abdominoplasty affecting retrograde ureteroscopic procedures.

## Key findings

- A patient with a history of Fleur-de-Lis abdominoplasty had altered anatomy that impeded cystoscope passage.
- The anatomical changes from abdominoplasty can interfere with endoscopic laser lithotripsy for kidney stones.

## Abstract

Abdominoplasty is a frequently performed elective procedure, often indicated for patients after substantial weight loss resulting in significant redundant skin. Closing techniques and the lifting of the mons pubis during abdominoplasty have been proposed to alleviate symptoms of stress urinary incontinence by elevating and supporting the urethra. Despite these observations, the impact of abdominoplasty on pelvic anatomy and subsequent endoscopic procedures remains underexplored and underreported. We present a case where cystoscope passage as part of endoscopic laser lithotripsy for nephrolithiasis was impeded by altered anatomy in a patient with a history of Fleur-de-Lis abdominoplasty.