From history and examination, it is clear that patient is a case of large renal pelvis stone with a sinus/fistula in the lumbar region. Other than ultrasonography, the simplest and easiest investigation one can perform is sinogram/fistulogram. A fistulogram was performed using water soluble contrast material, which revealed a fistula connecting the left kidney, pelvis, ureter, and urinary bladder (Fig. 1).
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