The ureter especially the lower ureter was tight and had to dilated with ballon dilatation under fluoroscopic guidance with contrast.We routinely do a check ureteroscopy with 6-7.5 rigid ureteroscope to see the ureteric anatomy before introducing the sheath.
We tried to introduce the sheath in this case but didnot allow beyond a few cms in ureter so it was kept there and through the sheath the flexible ureteroscope was introduced.The complete clearance was achieved and a 5 Fr DJ stent was kept ..
Thanks for sharing the information about the PRMARY RIRS:LOWER CALYEAL CALCULUS.
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