2017 Volume 30 Issue 1 Pages 111-114
A 43-year-old man was referred to our department for detailed examinations of macroscopic hematuria and left hydronephrosis, while receiving outpatient treatment for hypertension and diabetes mellitus in the department of internal medicine in our hospital. Computed tomography revealed a 15 × 8-mm stone in the left upper ureter. Because he was morbidly obese with a height of 185 cm and a weight of 156 kg (body mass index of 45.6), it was assumed to be difficult to administer extracorporeal shock wave lithotripsy with the device installed in our hospital. Thus, flexible transurethral lithotripsy (fTUL) was planned. After consultation with an anesthesiologist, we intubated the patient in an awake state to secure the airway and then performed fTUL under general anesthesia. The procedure was safely performed without major complications, and all stone fragments were removed.
