Sheathless synchronous flexible ureterorenoscopy with holmium laser lithotripsy in complete duplex renal collecting system with stones

Duplication of renal system is one of the commonest renal anomalies. It is infrequently associated with renal calculus, ureterocele and vesico ureteric reflux. We report a 29-year male with right complete duplex system having upper moiety multiple ureteric calculi and lower moiety inferior renal calculus. Single sitting fURS was done and calculi in both systems were tackled one at a time. Calculi were dusted with holmium laser and double J stent placed in upper moiety ureter. Calculus management in anomalous kidney is challenging. Single sitting flexible ureterorenoscopy is feasible option in duplex renal system with low burden calculi.