A 74-year-old female patient. She underwent LT Mini-PCNL on Oct. 5, 2015. She did not visit my hospital postoperatively even though she was aware of the necessity of removal of the left DJ catheter. Finally, she visited my hospital again 10 months after surgery (Aug. 2016) because of the persistent hematuria and flank discomfort.

You can see a 3cm-sized large bladder stone attached to the DJ catheter.There are multiple stones in the renal pelvis.

After I performed cystolitholapaxy, I inserted a terumo guidewire into the ureter. It was smoothly inserted next to the DJ catheter.

LT DJ catheter was removed and LT RIRS was additionally performed. The stone composition was COM 25%, CA 25%, struvite 50%. E.coli was identified.

The removed DJ catheter. Stones were impacted inside the catheter.

A ureteral catheter was inserted into the renal pelvis postoperatively and it was attached to the urethral foley catheter. This system is for irrigation in the renal pelvis.