9/13/2023 0 Comments Kidney stone staghorn calculus![]() In order to be able to treat these complex cases optimally, we must address two major gaps in clinical knowledge. However, it is a fact that there are patients with staghorn calculi who are either cannot safely undergo surgery or alternatively who refuse surgical management altogether. The advent of newer, smaller, and better surgical instrumentation and techniques over the past 30 years has revolutionized the modern urologist's ability to surgically removal large stones through a minimally invasive approach. In most cases, the cornerstone of management for staghorn calculi is maximal surgical removal. The presence of any component of calcium oxalate, uric acid, or cystine is indicative of an underlying metabolic abnormality, and these stones are commonly referred to as “metabolic” stones. Infection stones are strongly associated with urinary tract infections caused by urease-producing bacteria. The term “infection stone” is used to describe stones comprised of magnesium ammonium phosphate (struvite) with or without admixed calcium carbonate apatite (carbonate apatite). Patient history may also be revealing in this regard for instance, patients with infection staghorn calculi often report a history of recurrent urinary tract infections with or without fever. ![]() Staghorn calculi may be of metabolic or infectious origin, and whenever possible it is beneficial to obtain stone analysis data in order to determine this information for guiding treatment and patient counseling. (A) Skeleton of a stag moose, cervalces scotti, housed at the Royal Ontario Museum (B) Plain abdominal X-ray depicting bilateral staghorn calculi.
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