M/38, CT : Horseshoe kidney, LT lowerpole renal stone (near isthmus), HU812 (11x10x10, 8x6x6, 2x2x2mm), LT HUN (r/o Lt UPJ stenosis), RT UPJ stone.

Operative finding: RT distal ureter stricture (lower pelvic brim), RT UPJ 8 mm stone, LT distal ureter multiple strictures with HUN, LT UPJ mild narrowing (located LKMP), LT severe HUN, LT lower anterior caliceal large stone (inaccessible by flexible ureteroscopy)

Plan> RT RIRS and LT mini-PCNL via upper pole (Valvidia-Galdako position) > bilateral RIRS

Antiegrade flexible URS for access to the lower pole stone.