Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.

Introduction Cross‐fused renal ectopia is a rare congenital malformation, and few cases of urolithiasis have been treated by retrograde ureteroscopic lithotripsy. We report a case of urolithiasis in right‐to‐left and superior‐type cross‐fused renal ectopia, successfully treated by the retrograde approach. Case presentation A 69‐year‐old woman with two 14‐mm renal stones in cross‐fused renal ectopia underwent retrograde ureteroscopic lithotripsy. Although we did not recognize the anomaly preoperatively, we could diagnose urolithiasis in the ectopic kidney intraoperatively. The patient had no complication, and follow‐up computed tomography after 3 months showed only a 5‐mm renal stone. Conclusion Although urolithiasis in patients with cross‐fused renal ectopia is a challenging condition for the urologist, the retrograde approach is a safe and effective treatment method. It is necessary to carefully examine the urinary tract especially in a patient with a history of unidentified solitary kidney.

Introduction: Bladder paraganglioma is exceedingly rare, accounting for <0.05% of bladder tumors. This is a case of paraganglioma with no symptom other than palpitations during urination, with atypical imaging, resulting in acute respiratory distress syndrome after transurethral resection of the bladder tumor.Case presentation: A 46‐year‐old man underwent transurethral resection of the bladder tumor for a bladder tumor 61 × 52 mm in size on contrast‐enhanced computed tomography. The patient only had micturition attacks and was suspected to have urothelial carcinoma on magnetic resonance imaging. The patient had acute respiratory distress syndrome after the operation which improved conservatively. The ¹²³Iodine metaiodobenzylguanidine scintigraphy, urinalysis, and pathological examination revealed bladder paraganglioma. Robot‐assisted radical cystectomy and ileal neobladder reconstruction were performed.Conclusion: This study reported bladder paraganglioma with no symptoms other than micturition attacks in which acute respiratory distress syndrome occurred after transurethral resection of the bladder tumor.