Abstract
In recent years, there has been an increase in the number of patients with urolithiasis, which is associated with changes in lifestyle and nutrition. A clinical case of a 60-year-old patient with bilateral ureteral stones against the background of chronic calculous pyelonephritis and concomitant diseases demonstrates an effective approach to treating this problem. In 2024, a simultaneous operation was performed in the urology department of the State Budgetary Institution on the Right of Economic Management «City Multidisciplinary Hospital No. 2»: mini-percutaneous nephrolithotripsy on the left and ureteroscopy on the right using laser lithotripsy. The operation lasted 130 minutes, and despite the presence of bilateral stones, blood loss was only about 50 ml. No complications were observed, which corresponds to level 0 according to the Clavien-Dindo classification. The patient was discharged on the 6th day after the intervention, which indicates high efficiency and safety of the performed surgery. A review of the literature shows that simultaneous interventions such as mini-percutaneous nephrolithotripsy and ureteroscopy can significantly reduce the overall cost of treatment. They reduce the number of anesthesia and hospitalization time, which is also important for elderly patients with comorbidities. This approach not only minimizes surgical risks, but also increases patient satisfaction, as they can return to their normal life faster. The clinical case emphasizes that simultaneous mini-percutaneous nephrolithotripsy and ureteroscopy are a safe and cost-effective method for treating bilateral urolithiasis in elderly patients. This solution allows for effective management of the disease, improving the quality of life of patients and reducing the burden on medical institutions.