Figure 1.

Retained ureteral stent that had severe proximal and distal encrustations removed with a trimodal approach. The indwelling stent was fractured within the ureter for a prolonged time. The proximal end (shown in the right bottom corner) had severe encrustations and was retrieved separately via percutaneous nephrolithotomy (PCNL). The remainder of the stent (distal end) was retrieved via retrograde ureteroscopy and laser lithotripsy. In the center of the picture, a white nephrostomy catheter is seen; it was retained as well and retrieved at the time of PCNL. In the upper portion of the picture, numerous stone fragments are seen; they were all encasing the distal end of the ureteral stent and a cystolitholapaxy was also performed.