A 56 y old male with right upper ureteral stone, diabetes, vasculitis skin lesions afflicting 65% of body surface was referred for TUL, ureteroscopy revealed sever  upper ureteral stenosis and even stenting was impossible, stent was placed beneath stricture level and percutaneous nephrostomy was done, patient was scheduled for PCNl and antegrade access to upper ureter in 2 weeks pre – PCNl stenting was done by ureteroscope and fortuately the stone underwent  TUL

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