Staghorn Calculus: Its Clinical Presentation, Complications and Management

Abstract

Patients (95; 105 kidneys) with staghorn calculi were evaluated clinically and 84 kidneys were studied on a pathologic basis. Only 1% of the patients could be defined as having a silent stone calculus. Clinical complications occurred in 53% of the patients. Of 84 kidneys submitted for a pathoanatomic study (surgical evaluation and/or histopathology) pyonephrosis was found in 20%, xanthogranulomatous pyelonephritis in 8%, end stage pyelonephritic kidney in 6%, end stage hydronephrotic kidney in 7%, severe pyelonephritic changes in 7% and a perinephric abscess in 5%. The kidney was relatively undamaged in 51% of the cases. Complete removal of the calculus and appropriate medical adjunctive therapy should be done early in the course of the disease in an attempt to prevent complications and renal deterioration. The results are discussed and compared to those obtained in patients initially managed conservatively.