Abstract：Objective: To investigate the efficiency and safety of percutaneous nephrolithotomy with retrograde flexible ureteroscopy in the treatment of residual renal calculi after PCNL in second stage. Methods: We retrospectively reviewed the cases undergoing second-stage percutaneous nephrolithotomy with retrograde flexible ureteroscopy between March 2013 and September 2016. The patients were placed in the Galdakao-modified Valdivia supine position. Two urologists manipulated nephroscopy and regtrograde flexible ureteroscopy respectively in the same time. Results: Thirty-six cases were investigated, and the residual calculi S.T.O.N.E. scores were 6.7 in average. The procedure lasted 26.3 min. The stone free rate was 94% (34/36) without significant complications. Conclusions: Treating residual renal calculi after PCNL by percutaneous nephrolithotomy with retrograde flexible ureteroscopy is feasible and safe. It can make full use of the advantage of different instruments.
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