Use of a nasogastric tube to evacuate stone debris after ureteroscopic holmium lithotripsy

We report a case of bilateral struvite and matrix staghorn calculi in a quadriplegic man with severe upper and lower extremity contractures that prevented percutaneous nephrolithotomy. Bilateral ureteroscopic lithotripsy was performed but the 'snowstorm' of particles and viscous matrix material prevented complete stone clearance with the ureteroscope alone. Irrigation and aspiration through a fluoroscopically positioned nasogastric tube allowed evacuation of stone debris, mucinous matrix, and completion of the procedure.