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Successful tract creation was established in a second attempt in all of the patients failed in the first attempt. The groups were similar for stone-free and complication rates. Placement of guidewire down through the ureter could not be established in more than 60% of the cases. Location of guidewire prior to dilation did not affect the outcomes. Therefore, we suggest to proceed with tract creation even when the guidewire coils within the punctured calyx. Placement of guidewire down through the ureter could not be established in more tha