© 2013 Canadian Urological Association

Ureteral stent malposition outside of the urinary tract is a very uncommon complication of retrograde or antegrade ureteral stent insertion. There are few reports of open, laparoscopic or endou-rologic approaches to remove malpositioned stents. We present a novel technique for the removal of an extruded retroperitoneal ureteral stent using percutaneous antegrade nephroscopic holmium laser pyelotomy. This previously undescribed procedure represents a new soft tissue application of the holmium laser. Retrograde or antegrade ureteral stent placement is a common practice to relieve upper urinary tract obstruction, pain, or infection.1 Minor complications of ureteral stents include pain, voiding symptoms, hematuria and infection, and major complications of stents include encrustation, fragmentation, migration, malposition, knot formation, forgotten stents, extrusion and death.1-3 Ureteral stent migration is rare and involves movement within th