Horseshoe kidney is the most prevalent congenital kidney fusion anomaly, affecting 0.25% of the general population and occurring in 1 in 400-1600 births. Approximately 40 percent of patients develop kidney stones due to anomalies. In our case, we aimed to perform combined laparoscopic pyelolithotomy with retrograde intrarenal surgery (RIRS) instead of percutaneous nephrolithotomy (PNL) in a patient with a horseshoe anomaly. This procedure enabled us to detect the location of the mobile stone with RIRS and then successfully extract it with laparoscopic pyelolithotomy. Laparoscopic pyelolithotomy combined with RIRS is a reasonable additional treatment option for complicated stone surgery due to horseshoe kidney anomalies.

Renal calyceal diverticulum is congenital outpouchings of the renal calyx and communicate with the main collecting system via a narrow channel. Stones have reportedly been found in up to 50% of diverticulum. Surgical intervention is indicated for symptomatic stone. Stenotic infundibulum had been reported but seldom literature reported of calyceal diverticular atresia. Here we presented a case of atretic calyceal diverticular stone which successful managed by retrograde intrarenal surgery safely.