Successful Laparoscopic Ureterolithotomy to Remove a Large Ureteral Stone in an Infant: A Case Report

Pediatric urolithiasis, while rare, can result in significant morbidity; it typically presents with pain, irritability, and complications such as hydronephrosis and urinary tract infections. Conventional management techniques include extracorporeal shock wave lithotripsy (ESWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PCNL), with the choice guided by stone size, location, and patient age. In select cases - particularly those involving large or impacted stones where traditional methods may be inadequate - laparoscopic ureterolithotomy can offer a safe and effective alternative. We present the case of a 21-month-old infant referred from another hospital for a large left ureteral stone. On examination, the patient was irritable and difficult to console but hemodynamically stable, with no other abnormal findings. A non-contrast CT scan confirmed a 1.5 × 0.7 × 0.8 cm stone in the upper left ureter, accompanied by mild hydronephrosis. Laparoscopic ureterolithotomy was performed successfully, resulting in complete stone clearance without postoperative complications. This case underscores the importance of individualized treatment planning in pediatric urolithiasis and highlights the efficacy of laparoscopy as a viable option in complex cases where standard approaches may not be feasible.