Introduction. Calyceal fistula is a rare complication of a renal transplantation. This complication can lead to postoperative graft failure. The treatment approaches range from a partial nephrectomy to a routine nephrostomy.Objective. To present the successful application of the retrograde endoscopic-assisted percutaneous treatment of transplanted kidney calyceal fistula.Clinical case. A patient after kidney allotransplantation is under our care. Control postoperative ultrasound examination revealed a pararenal fluid mass in the left iliac region. Its percutaneous drainage was performed. Biochemical analysis revealed high levels of creatinine and urea in the drainage discharge. Despite ureteral stent and urethral catheter drainage, about 500 to 600 ml of urine per day was excreted by the drainage. Percutaneous puncture nephrostomy could not be performed due to the absence of dilatation of the renal cavity system. In the lithotomic position, the damaged calyx was identified by performing flexible ureteropyeloscopy. Then we percutaneously targeted the injured calyx and the distal end of the ureteroscope inserted transurethrally, so that the needle tip appeared in the paranephral cavity opposite the injured calyx. Under the control of a flexible ureteroscope the needle was inserted into the kidney pelvis, a nephrostomy tube 12 Ch was placed along the string. The discharge through the drain stopped within a week and it was removed. Follow-up examination nine weeks after surgery revealed that the patient had no complaints and renal ultrasound showed no features, so the nephrostomy tube was removed.Conclusion. The described method is the minimally invasive, affordable, and efficient method for the treatment of transplanted kidney calyceal fistula.

Introduction. The main treatment option for symptomatic ureteral stones is contact ureterolithotripsy (CULT), which is usually performed under Xray guidance. However, the risks of complications associated with radiation do not always justify the benefits obtained from its use, which justifies the study of the results of performing Х-ray-free ureterolithotripsy. Purpose. Evaluation of the efficacy and safety of non-fluoroscopic ureteroscopy in the treatment of symptomatic ureteral stones. Materials and methods. Data from 240 patients with ureterolithiasis who underwent CULT were retrospectively recruited. Clinical and demographic data of patients, stone parameters and intraoperative parameters were evaluated. A multivariate analysis of the above factors was carried out to determine their diagnostic value for predicting the results of CULT. Data collection and analysis was carried out using MS Excel and SPSS Statistics 22.0 tables, respectively. Results. The average stone size and density were 6,7±2,4 mm and 785,8±293,0 HU, respectively. The lasting of the surgery and the stone free rate were 39,5±14,6 min and 84,6%, respectively. Complications, in particular ureteral perforation, occurred in 17,0% and 6,7% of cases. According to the results of multivariate analysis, the following parameters influence the effectiveness of contact ureterolythotripsy (CULT) in symptomatic calculi: density, size and localization of the calculus, as well as the presence of ureteral stent (p <0.05). The preoperative indicators presented below significantly determined the frequency of complications: the density and localization of calculus, the presence of a ureteral stent, and the lasting of the surgery (p <0.05). Comparative analysis of CULT with and without fluoroscopy revealed identical results and the complications number. The repeated interventions were more frequent in patients without X-ray, but there were no a statistically significant differences between groups. Our data indicate that CULT without X-ray not compromising the effectiveness of the surgery. Conclusion. X-ray-free CULT for symptomatic ureteral stones eliminates possible complications from radiation without compromising the success of the operation itself