Treatment of staghorn calculi with extracorporeal shock-wave lithotripsy and percutaneous nephrolithotomy.
Between August 1983 and August 1987, 72 staghorn calculi were treated in 66 patients. Treatment was with percutaneous nephrolithotomy (PCNL) in 30, extracorporeal shock-wave lithotripsy (ESWL) in 18, combination PCNL-ESWL in 23, and nephrectomy in 1. Complications occurred in 59 percent of patients and were twice as common after PCNL as after ESWL. Radiologic follow-up on 69 kidneys (97%) showed 58 percent were stone-free, 15 percent had residual sand or matchheads less than 5 mm, 17 percent had residual fragments of 5-15 mm, and 10 percent had greater than 15 mm residual stone burden. With a mean follow-up of thirty months, 2 of 40 stone-free patients had persistent asymptomatic Proteus urinary tract infections, and 4 of 22 patients with residual calculi less than or equal to 15 mm required additional operative treatment.
Gleeson
M
M
Scott Department of Urology, Baylor College of Medicine, Houston, Texas.
Lerner
S P
SP
Griffith
D P
DP
D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000453:epidemiology / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects; D013997:Time Factors