Faculty:
Dr. Manoj Gupta (Consultant - Urology)
Dr Akshatta Sutkatti (Consultant - Anaesthesia) 

PRESENTING / CHIEF COMPLAINTS:
28 year-old male with a large left renal calculus, a large urinary bladder (vesical) calculus, and a forgotten DJ stent retained in the left kidney and urinary bladder for nearly 3–4 years following a previous surgery performed elsewhere.

CLINICAL FINDINGS:
* Large left renal calculus
* Large vesical (urinary bladder) calculus
* Forgotten/encrusted DJ stent retained for 3–4 years
* Complex stone disease requiring staged surgical intervention
* HBSAG - REACTIVE

DIAGNOSIS:
* Large Left Renal Calculus with Large Vesical Calculus associated with a Forgotten DJ Stent.
* HBSAG - REACTIVE

TREATMENT PERFORMED:

Stage I:
Endoscopic cystolithotripsy performed for the large urinary bladder stone.
Stone fragmented using Holmium Laser Lithotripsy.
Complete bladder stone clearance achieved.

Stage II (After 2 Weeks):
Mini Percutaneous Nephrolithotomy (Mini-PCNL) with Holmium Laser Lithotripsy performed for the large left renal calculus.
Complete renal stone clearance achieved.
DJ stent placed post-operatively.

HIGHLIGHTS OF THE CASE:
* Successfully managed a highly complex case involving a forgotten DJ stent with large kidney and bladder stones through a planned staged approach.
* Complete stone clearance achieved using advanced minimally invasive endourological procedures, including Holmium Laser Lithotripsy and Mini-PCNL.
* Patient recovered well with successful post-operative DJ stent placement.

SPECIAL NOTE:

This case highlights Dr. Manoj Gupta's expertise in managing complex urological stone disease using advanced minimally invasive endourological techniques, achieving complete stone clearance with faster recovery and excellent patient outcomes.