Stone Cone Device vs. Standard URS for Proximal Ureteral Calculi

Retrograde migration of stone fragments into the kidney during ureteroscopic lithotripsy (URS) for proximal ureteral stones is a common technical challenge, occurring in 5-40% of cases. This can lead to residual fragments and lower stone-free rates. The Stone Cone is an anti-retropulsion device designed to trap fragments and prevent their migration. This study will test the hypothesis that the use of the Stone Cone during URS pneumatic lithotripsy will result in a significantly higher stone clearance rate at 48 hours post-procedure compared to the standard technique without the device.

Inclusion Criteria: * A solitary proximal ureteral stone ≤ 2 cm in size as confirmed by imaging. * Normal renal function. Exclusion Criteria: * Active urinary tract infection (clinical features or pyuria). * Bleeding disorder (abnormal prothrombin time or activated partial thromboplastin time). * Chronic kidney disease (raised urea and creatinine). * Stone \> 2 cm in size.