Background: The most serious complication of ureter stent is long-term retention of ureteral stent and stone formation around the stent. Case presentation: A 51-year old female patient with left ureteral stent placed 2 years before developed both pyelic and vesical stones on the two ends of the double J was admitted to our hospital. Intravesical lithotripsy, retrograde ureteroscopy, and percutaneous nephrolithotripsy were performed with the patient in the prone splitleg position. All the stones and the ureteral stent were successfully removed in a single session. Conclusions: Combined endoscopic techniques in the prone split-leg position can effectively and safely manage severely encrusted stents.

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