Renal subcapsular haematoma secondary to the use of a flexible navigable suction access sheath in flexible ureteroscopy and Thulium Fiber Laser for an upper calyceal diverticular stone

A woman in her 50s, with a medical history significant for gastric bypass surgery and recurrent uncomplicated urinary tract infections, was referred to our institution for management of kidney stones. She had previously undergone a left flexible ureteroscopy (f-URS) at another hospital, which failed to achieve a stone-free status. Physical examination and laboratory findings were unremarkable. Urinalysis and urine culture were negative for leukocytes and bacterial growth, respectively. A contrast-enhanced CT scan revealed a 7×7 mm (380 mm³) stone located in a left upper pole calyceal diverticulum with a narrow diverticular neck ( figure 1).