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ABSTRACT Encrusted cystitis (EC) was first described as chronic cystitis with mucosal calcification in 1914 (1). It is a very rare chronic inflammatory disease presenting with dysuria, pelvic pain and gross hematuria. Voided urine contains mucus or calcified mucopurulent stone like particles. Urinalysis always reveals alkaline pH. It may be present in healthy individuals with no predisposing etiological factors (2-4). Etiologically, previous urological diseases, immunosuppression, urinary infection with urea splitting bacteria, or urological interventions resulting in bladder mucosa trauma may also be present (5, 6). In the present case report, we describe a novel treatment for EC with intravesical dimethyl sulfoxide.

Objective:Residual stone fragments remain a challenging topic for urologists following retrograde intrarenal surgery (RIRS). This study aimed to investigate the effectiveness of second-look flexible ureteroscopy (URS) to achieve a true stone-free status and decrease stone-related events.Materials and Methods:The study included 176 consecutive patients treated with RIRS for kidney stones between October 2013 and December 2017. Patients were divided into two groups. Group 1 included patients who underwent only one session of RIRS (n=51) and group 2 included patients who undergo a second-look flexible URS after RIRS (n=125). Both groups were compared for stone-free rates and potential risk factors associated with stone-related events. Stone-related events were defined as urinary infection, renal colic, stone enlargement, and any additional intervention with shock wave lithotripsy or reoperation.Results:Stone-free rate after RIRS for groups 1 and 2 were 37.25% (n=19/51) and 40.8% (n=51/125), respectively. The stone-free rates improved to 93.6% (n=117/125) in group 2 after the second-look flexible URS. The multivariable analysis revealed that type of intervention, stone size, and body mass index were independent prognostic factors for stone-related events. When group 2 was taken as a reference, the odds ratio for stone-related events was 8.48 (95% confidence interval: 2.95-24.42) in group 1.Conclusion:Second-look flexible ureterorenoscopy increased the stone-free rates and diminished the number of stone-related events. We argue that performing second-look flexible ureterorenoscopy in the early period following RIRS in the presence or suspicion of residual stone fragments provides better treatment results.