Objective: Stones are common mid- and long-term complications in urinary diversions built with bowel. However the reservoir intestinal loops can lead to difficult endoscopic approach.
Methods: We report two challenging cases with unfavourable anatomy successfully treated by gently handling a flexible cystoscope in a low pressure system.
Results: One patient with stones in a continent pouch was cleaned up with a grasping basket through the efferent umbilical limb. Another patient with an orthotopic ileal neobladder not accessible by rigid cystoscope due to high pelvic floor was treated with holmiun laser lithotripsy.
Conclusions: Urologists should consider the versatility of flexible cystoscope to obviate the need for percutaneous lithotripsy or open lithotomy.
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