Simultaneous Mini-ECIRS and low-energy TFL endopyelotomy for recurrent UPJO with pelvic renal calculus: A case report

Recurrent ureteropelvic junction obstruction (UPJO) with renal calculi poses a surgical challenge. Miniature Endoscopic Combined Intrarenal Surgery (mini-ECIRS) with low-wattage Thulium Fiber Laser (TFL) enables simultaneous stone clearance and precise endopyelotomy. We report a case of a 51-year-old woman with recurrent UPJO and renal stones treated using mini-ECIRS and TFL-assisted retrograde endopyelotomy. Dual endoscopic access allowed effective stone fragmentation and accurate UPJ incision. Operative time was 75 min, with no complications. This case supports mini-ECIRS with low-energy TFL as a safe, single-session treatment for recurrent UPJO with renal stones.