Backtable ureteroscopy for retrieval of retained stent or stone: A novel technique in renal autotransplant

Loin pain hematuria syndrome (LPHS), first described in 1967, is a disorder of chronic, severe flank pain without an identifiable source. Patients suffer from extreme unilateral or bilateral flank pain accompanied bymicroscopic or gross hematuria.1 The etiology behind this syndrome remains unclear. Pathophysiologic mechanisms of LPHS include immune hypersensitivity, abnormal glomerular basement membrane thickening, somatization, abnormal ureteral peristalsis, intratubular calcium deposition, and nephritis; however, the diagnosis of LPHS remains a diagnosis of exclusion.2 Diagnostic criteria include characteristic renal pain present for at least 6months requiring substantial opioid therapy as treatment, hematuria present in multiple urinalyses, and lack of other etiology of symptoms. Evaluation often includes urinalysis, renal ultrasound, abdominal CT scan, and renal biopsy.1 Despite multiple proposed interventions, many patients suffer from this pain for years, requiring chronic use of opioids, before ultimately receiving curative treatment. Medical therapies