A 50-year-old man presented to an outpatient urology clinic with left-sided flank pain. He had received treatment for a left renal pelvis calculus 5 years earlier; shock wave lithotripsy had been unsuccessful and ureteroscopic laser lithotripsy had left the patient with a 2 mm residual stone fragment. The fragment was deemed clinically insignificant, and the patient remained asymptomatic without any further follow-up.Investigations
Physical examination, CT of the abdomen and pelvis, and complete metabolic evaluation.Diagnosis
Left lower pole renal calculus and idiopathic hypercalciuria.Management
The patient was counseled about his treatment options, and he elected to undergo percutaneous nephrolithotomy. After a single-stage procedure, CT confirmed a stone-free state. The patient was administered thiazide therapy and dietary counseling to treat his hypercalciuria. This condition resolved, and the patient remained stone-free 1 year after treatment.