PMC4996574_01
Noncontrast CT demonstrating nongravity-dependent calcifications at the left ureteropelvic junction with accompanying hydronephrosis.
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Before our encounter, she underwent a CT scan that demonstrated left hydronephrosis and irregular calcifications at the left UPJ that were nongravity dependent (Fig. 1).
Appearance of calcified sutures in left renal pelvis.
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Ultrasonic lithotripsy (CyberWand, Olympus) was first used for reduction of stone burden and to provide exposure of suture material (Fig. 2).
Application of tension on the suture material through nephroscopy enables ureteroscopic transection of the foreign body at the level of the urothelium and eliminates the foreign body from future urine exposure.
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Two surgeons then worked in synchrony, using a grasping instrument through the nephroscope to apply tension to the permanent suture material and permit transection through holmium: YAG laser lithotripsy at the level of the urothelium (Fig. 3).