| Summary: | Large ureteral calculi are commonly associated with severe colic pain, complex urinary tract infections, severe hematuria, hydronephrosis, and renal deterioration, often requiring immediate surgical intervention. Ureteroscopy is a favored treatment due to its higher stone-free rates; however, it encounters difficulties in cases of a high burden of distal ureteral stones. We present a case where a patient with a significant ureteral calculus was effectively treated with a vacuum-assisted mini-percutaneous nephrolithotomy system in retrograde approach. This intervention enabled the complete removal of the stone, leading to the patient's full recovery without complications.
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