Staghorn Calculus with Duplex Pelvicalyceal System

Duplex pelvicalyceal system is characterised by presence of two separate pelvicalyceal system with complete or incomplete duplication of ureter. It is seen in 1% of adult population. 75 year old male patient presented with right sided intermittent colicky pain in flank since 1 year. History of recurrent episodes of urinary tract infection in the past 1 year. Tenderness present in right lumbar region on bimanual palpation. Large staghorn calculus of size 1.9? 1.4? 2.4cm seen in lower moiety of the right sided pelvicalyceal system with moderate hydronephrosis on CECT abdomen +pelvis. Evidence of large staghorn calculus in lower moiety of duplex pelvicalyceal system intraoperatively. Pyelolithotomy with D-J Stenting with Pyeloureterostomy. In patients with Duplex pelvicalyceal system, increased chances vesicoureteric reflux, ureteroureteric reflux which leads to increased chances of stone formation particularly in lower moiety of duplex pelvicalyceal system.