there are different complications of using ureteral stents in urology field, one of the challenging complications is stent fragmentation which is frequent in patients with missed and forgotten stents accompanying encrustation, presented case was 70- year-old female, left single kidney with stent fragmentation After TUL and stent insertion one year ago, because of retained fragments in kidney, ureter, and bladder, combined antegrade and retrograde approach was used for stent fragments extraction, for preventing stent related complications we should signify the importance of timely extraction of ureteral stents during inpatient and outpatient visits and using remembrance methods.

Background Pheochromocytoma is a rare tumor originating from the adrenal medulla, and surgical removal is the main treatment. We report a case of large size pheochromocytoma that was removed laparoscopically without preoperative blockade of alfa adrenergic receptors. Case presentation A 58-y-old woman was referred to our center with incidentally found 7 cm right adrenal mass. She did not have any history of hypercatecholamine state, and 24 h urine test for catecholamine metabolites was in normal range; we thought there is no need for preoperative catecholamine blockade. She was scheduled for laparoscopic mass resection, and during the operation, there was no significant bleeding and no major hypertension or hypotension crisis. The final pathology report was pheochromocytoma. Conclusion As the catecholamine release of pheochromocytoma may be periodic and inconsistent, the preoperative test should be repeated especially for large adrenal tumors.

Introduction: During recent years, considerable efforts have been expended into the management of urinary stone. Here, we present our experience on ureteric stone removal without any lithotripsy interventions. Combination direct vision with basket en-trapping provided a new dimension to our ureteroscope experience. Materials and methods: Here, we reviewed the medical data of our adult patients with ≤10 mm stone size, who received primary stone extraction under direct ureteroscopic vision without lithotripsy during a 2-year period. During the six months of follow-up every patient was seen frequently. Results: The study included 69 patients from both sexes with ages ranging from 18 to 68 years. We obtained 92.7% success rate. The average length of operative procedures was 25.3 ± 10.4 min with a 14.4 % complication rate. Conclusion: Ureteral stone extraction requires considerable caution and may be associated with some complications. Stone extraction under direct ureteroscope guidance facilitates this procedure, especially in the distal stones. It seems combination direct live imaging with basket en-trapping may be helpful in these precise cases.

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