Flexible Ureteroscopy-Directed Retrograde Nephrostomy for Percutaneous Nephrolithotomy: Description of a Technique

We describe flexible ureteroscopy-directed retrograde nephrostomy access using a puncture wire to achieve renal access. This is a natural extension of modern retrograde intrarenal surgical techniques and a modernization of the original Lawson technique for retrograde nephrostomy tract creation. In appropriately selected patients, this approach is safe and permits reduced radiation exposure. We believe this technique is easy to learn and may overcome the difficult learning curve of antegrade nephrostomy techniques faced by urologists who have not undergone subspecialty training in endourology.