Abstract
The treatment of stones within Kock pouch urinary diversions is challenging yet gratifying in terms of reduction of symptoms. Using endoscopic means, the procedures can be done totally on an outpatient basis, with a considerable reduction in cost. Extracorporeal shock wave lithotripsy has limited, if any, place in the treatment of this particular urologic problem. If a full endourologic armamentarium is not available, the procedure can be accomplished with an operating nephroscope, direct grasping instruments, and an electrohydraulic probe, although the procedure may take longer. Technical modifications in the construction of the Kock pouch, and possibly routine postoperative endoscopy to remove any exposed staples, and considerably reduce the incidence of this complication.
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