Challenging management of coralliform kidney and ureteral stones

Coralliform kidney stones represent a severe form of nephrolithiasis, posing significant challenges due to their size and associated complications, such as recurrent infections and renal impairment. We present the case of a 34-year-old female with chronic venous disease, anemia, and recurrent <i>Escherichia coli</i> urinary tract infections, who was diagnosed with a right-sided coralliform renal calculus and a ureteral pelvic stone. The management included semi-rigid ureteroscopy with laser lithotripsy for the ureteral stone, percutaneous nephrolithotomy (PCNL) for the coralliform stone, and placement of a ureteral stent. Despite anatomical challenges during PCNL, residual stones were addressed via staged extracorporeal shock wave lithotripsy. This case highlights the complexity of surgical management in advanced nephrolithiasis and the necessity for a multidisciplinary approach.