Laparoscopic Ureterolithotomy in a Patient with Severe Lumbar Scoliosis and Large Proximal Ureteric Calculi

This case report outlines the effective management and outcome of a 26 years old male patient with lumbar scoliosis and multiple large left ureteric calculi with moderate hydronephrosis. The patient visited the outpatient urology department with a complaint of left flank pain persisting for four months. Imaging revealed multiple large stones in the left proximal ureter, with the largest measuring over 3 cm. Because of the anatomical complexities associated with severe lumbar scoliosis and the significant stone burden, the patient was not an ideal candidate for extracorporeal shock wave lithotripsy (ESWL) or ureteroscopic lithotripsy (URSL). Instead, laparoscopic ureterolithotomy was successfully performed, yielding favorable results. This report examines the surgical approach, challenges, and benefits of laparoscopic ureterolithotomy in comparison to other treatment options, including percutaneous nephrolithotomy, open ureterolithotomy, extracorporeal shock wave lithotripsy, and laser lithotripsy.