Srithongsongsaeng P.Sirisopana K.Piyawannarat S.Phengsalae Y.Sangkum P.Kongchareonsombat W.Ketsuwan C.Mahidol University2025-06-062025-06-062025-07-01Urology Case Reports Vol.61 (2025)22144420https://repository.li.mahidol.ac.th/handle/123456789/110483Urolithiasis in renal allografts can cause serious complications, particularly when involving calyceal diverticula due to altered anatomy. We report the case of a 44-year-old female recipient of a kidney transplant who presented with recurrent urinary tract infections and elevated serum creatinine levels. Imaging revealed a calyceal diverticular stone. After a failed retrograde approach, she underwent vacuum-assisted mini-endoscopic combined intrarenal surgery (ECIRS). A flexible ureteroscope enabled precise puncture and direct visualization for diverticular neck incision and fulguration. The procedure was successful with no complications. Vacuum-assisted mini-ECIRS is a safe and effective option for complex stone cases in recipients of transplants.MedicineArticleSCOPUS10.1016/j.eucr.2025.1030792-s2.0-105006649364