The management of large, impacted upper ureteric calculi remains challenging for urologists. Various treatment options include extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopic lithotripsy (URSL), percutaneous nephrolithotripsy (PCNL), laparoscopic and open ureterolithotomy. ESWL has poor overall success rate in the treatment of large stones with a significant possibility of residual fragments. Semi-rigid or flexible ureterorenoscopy with Holmium: YAG laser lithotripsy (URSL) has a stone-free rate of 89-100% in managing proximal ureteral calculi [1-7]. However, large and impacted proximal ureteral stones are difficult to approach. PCNL was introduced as an alternative treatment for large renal and proximal ureteric stones and achieved success in the 1980s [8]. Minimally invasive PCNL (mini-PCNL), which is a modified PCNL using a miniature endoscope by way of a small access tract, can be routinely performed to manage stones in the kidney and proximal ureter [9]. PCNL is shown to have a higher success rate compared to other minimally invasive procedures. However, bleeding and fever are the common complications. Conservative management suffices in majority of patients with such complications. Rarely, blood transfusion may be needed. Laparoscopic ureterolithotomy [10,11] is associated with a shorter period of convalescence when compared to an open procedure, but is associated with a higher learning curve. Open ureterolithotomy is indicated for failure of all minimally invasive modalities, in presence of a concomitant open procedure, and the presence of large impacted stone where patients don't consent for multiple procedures [12]. The present study was taken up to analyse two minimally invasive surgical procedures, mini-percutaneous nephrolithotripsy (mini-PCNL) and ureteroscopic pneumatic lithotripsy (URSPL), in the treatment of large (>15mm), impacted, upper ureteric stones (from PUJ to lower border of L4 vertebra) and to compare the therapeutic outcome, merits and demerits of each procedure.

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.We used diagnostic and operative laparoscopy in the management of 52 patients with 61 undescended testes. Boys with the palpable testis at any point were excluded from the study. Results: Out of these patients 26(boys), 28 testes (45%) were palpable and 26(boys), 33 testes (54%) were Nonpalpable. Age range from 9 months to 17 years (median age 5.3 years) .Out of 33 Nonpalpable testes 7(21%) were on the right side, 12(36%) on the left and 14(42%) bilateral. Diagnostic Laparoscopy Findings (n= 33) 1. Deep ring was open in 25(75.7%) and closed in 8(24.2%). 2. Vas and Vessels were seen entering the deep ring in 3 patients and thus inguinal exploration carried out 3. Morphology of testes were Hypoplastic 11(33