How to manage an impacted UPJ stone by RIRS

Information. - 1.8cm sized UPJ impacted stone and some additional small renal caliceal stones

Ureteral access sheath positioning:

- about 3 cm below the UPJ stone

0:00 - 7:26.

- Initial dusting with low pressure by manual irrigation not to move the stone, Escargo technique (dusting from outside to inside) 7: 26 - 8: 15.

- Trendelenburg position and stone migration to upper or midpole calyx 8:15 - 10:16.

- Basketing the small fragmented stone to analyze stone composition and culture 10:16 - End.

- Final dusting for complete stone-free status