Retroperitoneal laparoscopic pyelolithotomy as salvage therapy for refractory infectious renal calculi: A case report.

Refractory infectious renal calculi with severe pyonephrosis pose a clinical dilemma due to ineffective drainage and contraindicated percutaneous nephrolithotomy (PCNL). We report a 56-year-old male with diabetes and paraplegia who developed left renal pelvic calculi (2.5 cm) with refractory infection after failed stenting/nephrostomy. Retroperitoneal laparoscopic pyelolithotomy was performed, achieving complete stone removal and pus drainage. The patient recovered uneventfully with no infection recurrence at 3-month follow-up. This procedure is a safe, effective minimally invasive salvage therapy for PCNL-ineligible patients with refractory infectious renal calculi, with high clinical application value.