Clinical case of a bilateral ureterocele with formation of a large ureteral calculus

In modern urological practice, anomalies of the urinary system development, such as ureterocele, often become an etiological factor for severe forms of urolithiasis. This clinical case of a 42-year-old female patient with bilateral ureterocele complicated by a large ureteral stone amidst obstructive uropathy demonstrates the capabilities of modern minimally invasive surgery in treating rare congenital pathologies in adults. In 2025, at the urological department of the SME on REM «Municipal multidisciplinary Hospital No. 2» (Astana c., Republic of Kazakhstan), a simultaneous endoscopic operation was successfully performed: bilateral laser ureterocele incision combined with contact laser lithotripsy.

The diagnostic algorithm, based on multispiral computed tomography, allowed for a detailed verification of the anatomical features of the malformation and the density of the calculus. Despite the complexity of the simultaneous intervention, the operation was characterized by minimal invasiveness and an absence of intraoperative complications. A positive clinical trend was observed in the postoperative period: complete stone destruction was achieved, adequate urodynamics were restored, and renal function was stabilized (glomerular filtration rate 86-89 mL/min/1.73 m²). The patient was discharged in satisfactory condition, confirming the high efficiency of the chosen strategy.

Analysis of this case within the context of current literature shows that simultaneous laser interventions significantly reduce the duration of inpatient treatment, minimize the anesthetic burden, and avoid staged surgeries. This approach not only reduces the risk of iatrogenic complications but also facilitates the rapid socio-occupational rehabilitation of patients. The presented clinical case emphasizes that transurethral laser ureterotomy is a safe, cost-effective, and gold standard treatment for ureterocele, providing reliable prevention of recurrent obstruction and preservation of the renal reserve.

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