Background Cross-fused renal ectopia (CFRE) is a rare congenital anomaly in which an ectopic kidney crosses the midline and merges with the orthotopic kidney on the other side. Patients with CFRE could present with urolithiasis. The abnormal anatomy and the lack of consensus to treat urolithiasis in these cases present challenges to treatment. In this study, we present a case of renal stone in a CFRE managed through percutaneous nephrolithotomy (PCNL). Case Presentation We present a case of a 59-year-old man with right flank pain. Radiologic studies showed a 2 cm renal pelvis stone in a CFRE. The patient was effectively managed with PCNL. Conclusion With proper radiologic study and thorough understanding of the aberrant anatomy, PCNL represents a safe and effective treatment for patients with renal stones in CFRE with high stone-free rate and low mortality.Background A large or persistent urethrovesical anastomotic leakage after a laparoscopic or robot-assisted laparoscopic radical prostatectomy (RALRP) although infrequent can be a difficult complication to treat. We describe a simple technique to facilitate resolution of a urethrovesical anastomotic leak by exchanging the in-place bladder Foley catheter for a pigtail drainage catheter. Case Presentation Between 2014 and 2019, we had three patients who had a large/persistent urine leak after a radical prostatectomy (one laparoscopic and two robot assisted). All three patients had a wide bladder neck requiring bladder neck reconstruction with ureteral orifices close to the anastomosis. The bladder Foley catheter was exchanged to a pigtail Cope loop catheter™ (14F) or an Origin™ self-retaining drainage catheter (16F) under flexible cystoscopic guidance over a guidewire. Placement of a Cope loop bladder catheter stopped anastomotic leakage expeditiously with no need for further intervention. At minimum 3 months follow-up none had bladder neck stricture with 0-1 pad urinary incontinence. Conclusion Drainage of the bladder through the use of a loop pigtail nephrostomy catheter can be useful in rapidly resolving a large persistent urethrovesical anastomotic leak.Background Nonabsorbable sutures used during renal surgery represent a known substratum for stone growth. We hereby describe two cases of nephrolithiasis secondary to permanent suture material, originally placed during conservative renal surgical procedures and afterward migrated into the caliceal system, managed with endoscopic combined intrarenal surgery (ECIRS) with subsequent complete renal clearance. https://www.selleckchem.com/products/AR-42-HDAC-42.html . A 54-year-old male, with history of laparoscopic excision of a left parapelvic cyst, presenting with left inferior caliceal stone. Case 2. A 79-year-old female, who underwent open enucleation of a left renal pelvis tumor 15 years before. #link# She presented with bilateral lithiasis, including a staghorn stone in the left renal pelvis. Both patients underwent left ECIRS by two surgeons, revealing the presence of suture devices, which were completely removed. Abdominal CT at 1 month after surgery did not show residual lithiasic fragments in both cases. Conclusion To prevent the risk of stone formation, it is mandatory to use nonabsorbable suture agents sparingly during conservative renal surgery and furthermore to remove all foreign material from the collecting system because they have the potential for calculi growth. In this sense, ECIRS technique may also avoid further open or minimally invasive surgery and the use of suture instruments.Background Since its first description, laparoscopic adrenalectomy has become the gold standard for the surgical treatment of adrenal tumors. In patients who have previously undergone major transperitoneal or retroperitoneal surgeries, a retroperitoneal access through a virgin thoracic cavity might be the only alternative for a minimally invasive approach. Case Presentation We report a case of a 61-year-old man with a history of retroperitoneal nephrectomy caused by renal cell carcinoma. He then developed a cancer recurrence in the left renal fossa, which was rescued with a transperitoneal laparotomy. During surveillance, a CT scan revealed two lung nodules and an adrenal tumor, a biopsy of which confirmed as relapsed kidney cancer. The patient had a good performance status so pazopanib (800 mg/day) was initiated, with a partial response in the adrenal tumor. Considering the patient's background, he was regarded as an appropriate candidate for a thoracoscopic transdiaphragmatic adrenalectomy. The patient was operated under general anesthesia, with selected double-lumen endotracheal intubation in lateral decubitus position. Once transthoracic ports were placed, the diaphragm was incised, exposing the retroperitoneal space. At this stage, the adrenal mass was identifiable and dissected free from surrounding structures. There were no intraoperative and postoperative complications. The patient was discharged after surgery without opioid requirement. The pathology report confirmed the relapsed renal cancer with negative surgical margins. The patient was alive and without a kidney cancer relapse at his last follow-up visit. Conclusions As we described in our case, thoracoscopic transdiaphragmatic adrenalectomy might be taken into consideration in patients with a history of previous major transabdominal or retroperitoneal surgeries. In addition, the lateral decubitus position might be advantageous for anesthetists unfamiliar with the prone position.Urinoma is a possible complication of ureteral lithiasis. Urine extravasation is normally localized in the retroperitoneum. We describe a rare case of hydrocele secondary to urinoma, resolved with ureteral stenting.Background There are limited data about urolithiasis in young infants, especially in class age younger than 2 years. Case presentation We report the case of a child less then 2 years old (13 months) affected by metabolic urolithiasis (cystinuria), and renal hypertension. He was admitted to our ward from the pediatric emergency room for fever, lack of appetite, irritability, and abdominal pain crisis. Ultrasonography (US) described a huge stone (15 mm) in dilated left renal pelvis (20 mm) associated with distal ureteral ectasia (7 mm). Urine and blood diagnostic assessments were performed. Hydropenic therapy and urine alkalization were started without success. The child underwent an ureteroscopy (URS) with a 4.5-6.5F rigid ureteroscope aiming to reach the renal pelvis and perform holmium yttrium-aluminum-garnet laser stone disintegration. During the procedure, the ureter presented two unexpected stones in the distal portion (missed on US). A laser ureteral lithotripsy was effectively performed extracting smaller stone fragments.