Renal staghorn calculosis: our experience with the percutaneous treatment with or without extracorporeal shock wave lithotripsy

OBJECTIVES: In this paper we report our results in the treatment of renal staghorn stones by percutaneous lithotripsy (PCNL) with or without extracorporeal shock wave lithotripsy (ESWL). METHODS/RESULTS: Over a period of 5 years, 244 patients with renal calculosis were treated by PCNL in our Department. Seventy-four of these were cases of renal staghorn calculosis: 44 presented a partial staghorn stone and in 30 cases the stone formation completely occupied the pyelocalieal cavity. We performed first a PCNL via a rigid nephroscope. Stones were crushed using an ultrasonic lithotrite; an electrohydraulic probe was used when the calculus was resistant to ultrasound. The patients were submitted to one or more percutaneous treatments followed by extracorporeal lithotripsy to complete the operation, when required. The patients were divided into two groups according to the type of stone: the first group comprised 59 patients with a partial or complete simple staghorn stone and the second comprised 15 patients with a complete complex staghorn stone. Complete resolution was achieved in 55 of the 59 cases (93.2%) in the first group and in 9 of the 15 cases (60%) in the second. We had no complications. CONCLUSIONS: Our experience confirms that PCNL is the elective treatment for partial and complete staghorn stones and ESWL in these types of stones must be utilized only as ancillary treatment for residual fragments