Management of renal calculi after ileal conduit diversion is challenging because of altered urinary tract anatomy. We report a patient with a large renal stone successfully treated using staged retrograde flexible ureteroscopy. A Wallace-type uretero–conduit anastomosis permitted smooth retrograde access and selective use of a ureteral access sheath, enabling effective stone clearance. Reference is made to our broader experience to illustrate how unfavorable anastomotic anatomy may limit device selection. These findings emphasize the importance of tailoring retrograde stone management according to anastomotic configuration.
Katsui et al. (Sun,) studied this question.