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Horseshoe kidney is one of the most common congenital renal abnormalities with increased incidence of stone formation. We present a case of an HIV seropositive patient with a both-ends encrustated 3 year forgotten DJ stent and a staghorn stone in the left moiety of a horseshoe kidney. He was treated with percutaneous nephrolithotomy in the supine flank free modified position and simultaneous cystolitholapaxy. Supine percutaneous nephrolithotomy is safe and feasible in horseshoe kidney and facilitates simultaneous thansurethral access for cystolitholapaxy.

Percutaneous Nephrolithotomy in the supine flank free modified position for the removal of a 3 year Double-J ureteral stent in a horseshoe kidney