Successful percutaneous flexible ureteroscopy for treatment of distal ureteral stones under modified Valdivia position after Cohen reimplantation.

Introduction Endoscopic retrograde access to the upper urinary tract after Cohen reimplantation for the treatment of vesicoureteral reflux in children is usually difficult. Case presentation We experienced a case involving a few large ureteral stones in the right distal ureter after Cohen reimplantation. We initially failed retrograde access using flexible cystoscope. Therefore, we performed antegrade flexible ureteroscopy through the 10- to 12-Fr access sheath from the middle calyx to treat the few ureteral stones (>1.5 cm) in the right ureter with the patient in the modified Valdivia position. This one-stage procedure was successful. The patient achieved a stone-free status without major complications. Conclusion The herein-described approach that was implemented after Cohen reimplantation was successful. We believe that recent endourologic developments contributed to the good outcome in this case.