First application of a 6.3 Fr flexible ureteroscope in the treatment of bilateral staghorn calculi: A case report

Rationale: Staghorn calculi are a challenging type of kidney stone traditionally treated with percutaneous nephrolithotomy (PCNL) or multiple endoscopic procedures. However, these methods are often associated with a higher risk of postoperative complications and prolonged recovery periods. Recent advancements in flexible ureteroscopy (fURS) technology have offered the potential for improving the management of kidney stones, but its application in treating complex staghorn stones remains limited due to technical and anatomical challenges. Patient concerns: A patient presented with bilateral staghorn calculi, which posed significant challenges for treatment due to their size and complexity. The patient was concerned about the risks associated with the traditional methods, including postoperative infection, long recovery times, and potential complications. Diagnoses: The patient was diagnosed with bilateral staghorn calculi, large and complex stones that require a highly specialized approach for effective treatment. Interventions: A novel approach was used to manage the patient’s bilateral staghorn calculi using a 6.3 Fr flexible ureteroscope. Complete stone clearance was achieved using 2 procedures. The smaller sheath diameter of the 6.3 Fr flexible ureteroscope provides several advantages, including improved lithotripsy efficiency, reduced intrarenal pressure, and enhanced irrigation flow. Outcomes: Use of the 6.3 Fr flexible ureteroscope resulted in complete stone clearance with minimal postoperative complications, such as infection. This procedure demonstrated high efficiency and precision, highlighting the potential of advanced fURS technology for the treatment of complex kidney stones. Lessons: This case highlights the advantages of utilizing the 6.3 Fr flexible ureteroscope in the management of complex kidney stones, particularly staghorn calculi. These findings suggest a higher single-stage surgical success rate and fewer postoperative complications. This approach reflects the evolving field of endourology and demonstrates the potential for broader applications of the advanced fURS technology.