A 45 year old gentleman came with pain in left kidney. He was a case of left solitary left kidney. On evaluation he had three stones - one of 1.6 cm in the left renal pelvis, and two of 5-6 mm in the left middle calyces.
He had come from Malaysia for RIRS and stone clearance. We did RIRS and could clear the renal pelvic stone but as the stone bulk was higher and the kidney was solitary functioning; we decided to stop the procedures once the fragments were scattered to the calyces.
We took him up for ESWL session on the very next day and there was a complete clearance during ESWL. We had to deliver around 3500 shocks to the two calculi.
We have kept a 5Fr DJ stent and planning for stent removal after 1 month.We have asked him to get it removed at Malaysia.