management for urolithiasis. Complications of ureteroscopic procedures are often mild and need only conservative treatment, while there are still some severe and fatal complications. Renal subcapsular hematoma is not an uncommon complication after extracorporeal shock wave lithotripsy, trauma, renal angiographic procedures and spontaneously in patients of malignancy and in patients on anticoagulation. But only few cases of subcapsular hematoma after ureteroscopy has been mentioned in

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... Conclusion: In this article, we presented a rare case of SRH after URSL with lithocast. This 55 year-old female patient visited urology clinic due to persisted left flank pain after URSL 1 month ago. Serial image study revealed residual left lower ureter stone with hydronephrosis. Repeated left ureteroscopic stone manipulation with lithoclast was arranged then. However, she returned to emergent department due to severe left flank pain and reduced hemoglobin level. Computed tomography showed a 12*6.6*1.5cm hematoma over subcapsular space of left kidney. Clinical spectrum of subcapsular hematoma following ureteroscopy varies and management options depend upon the severity of hematoma. We discussed the possible risk factors, causative mechanism and management of this patient and also reviewed literatures concerning incidence, proposed mechanism, prevention and management of subcapsular hematoma following ureteroscopic procedures.