Unilateral Ureterocele Presenting With Multiple Stones In An Old Lady: Endoscopic Incision and Stone Extraction

In this video supported case report, we aimed to present our step-by-step technique of endoscopic incision of ureterocele and stone extraction in a 66 years old female  patient with a large ureretocele containing multiple urinary stones. The patient was with the complaints of flank pain and disuria. The patient  was prepared under spinal anesthesia and positioned in lithotomy position. Under direct visualisation of cystoscopic view, the ureterocele and other ureteral orifice of the duplicated urinary system have been detected. A ureteral catheter was placed into the other ureter for safety. Subsequently, a transverse endoscopic incision was performed by using a 26 F standard resectoscope with an electrical loop of TUIP at the inferior lateral border, and an artificial secondary ureteral orifice has been created. Though this new orifice, the resectoscope was inserted into the ureter, and multiple ureteral stones were seen inside the ureterocele and dilated ureter. These stones were extracted by using stone forceps and directly irrigation and decompression of the ureteral lumen. No stone fragmentation was required in this operation. After the elimination of all of the stones, a 4.8 F DJ stent was inserted into the ureter and the procedure has been completed without any complication. At the postoperative follow up period, no complication was occurred and all of the complaints were improved.