Management of nephrolithiasis within a pelvic kidney presents a novel challenge to the urologist. We report on a patient who underwent ureteral stent placement prior to extracorporeal shock-wave lithotripsy (ESWL). Following ESWL, the ureteral stent calcified at the vesical and renal ends, requiring "sandwich therapy" of percutaneous nephrolithotripsy, ESWL, and percutaneous nephroscopy. Percutaneous access to the pelvic kidney through a posterior approach was complicated by femoral neuropathy manifested by an inability to walk. With 6 months of aggressive physical therapy, the patient is now able to ambulate with difficulty using a walker.
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