This report presents the case of a 63-year-old man who presented with recurrent visible haematuria and loin pain 18 months after open partial nephrectomy for renal cell carcinoma. A computed tomography urogram revealed three obstructing calculi in the mid-to distal ureter with hydronephrosis. Rigid ureteroscopy revealed three calcified objects in the pelvic ureter. These had the appearance of calcified Weck Ò clips. A laser was used to remove the calcification, confirming the presence of three Weck clips, which had been used for haemostasis during the partial nephrectomy. These were removed with graspers after balloon dilatation of the distal ureter. This phenomenon of multiple clips migrating with stone formation and obstruction of the ureter was named "clip-strasse".

Results show that intraoperative, surgical specimen (ex vivo) US control of resection margins in patients undergoing PN is feasible and efficient. It represents a promising tool to ensure margin negativity during PN.

Objective: To assess the safety of shock wave lithotripsy (SWL) without prophylactic stents in solitary functioning kidneys. Patients and Methods: Sixteen solitary functioning kidneys with 23 renal stones with a size of <15 mm were treated with SWL as the primary modality. All patients were counseled about the possibility of obstruction, and treatment was offered to those who consented. The safety of SWL was assessed by the need for interventions and the posttreatment renal function. Results: In 14 patients lithotripsy was uneventful. The duration of treatment ranged from 5 to 35 days. One patient with a 15-mm pelvic calculus presented with anuria which resolved before intervention. In 1 patient fragmentation failed, and percutaneous nephrolithotomy was performed. Conclusions: In solitary functioning kidneys, SWL is safe without prophylactic stents in properly selected and closely monitored patients. Avoiding stents decreases costs, duration of treatment, and stent-related morbidity without unduly compromising safety.

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