On average, PNL requires 1.9 total procedures while combination therapy and SWL require 3.3 and 3.6 total procedures, respectively. The overall estimated stone-free rate following treatment is highest for PNL (78%) and lowest for SWL (54%).Ĭomparing PNL with combination therapy, stone-free rates are higher with PNL (78% versus 66%, respectively) and PNL requires fewer total procedures (1.9 versus 3.3, respectively). Some technical answers to those questions follow: A useful way to interpret this information is to consider the following: a staghorn stone can pose a significant risk to a patient’s health what are the types of help that are available what are the hazards that go along with the efforts to help? To help decide how to proceed, it is worthwhile to consider the stone-free rates and the potential complications. If the kidney does not work, and there’s chronic infection or pain, then removal of the kidney may be recommended (see nephrectomy newsletter). An imaging study called a Lasix renal scan may help determine if the Kidney has any significant function. In some cases the staghorn stone may have already caused significant damage to the affected kidney and the kidney may not contribute much to the overall level of a patient’s kidney functioning. Types of treatment include: Percutaneous nephrolithotomy (PNL), combinations of PNL and shock-wave lithotripsy (SWL) (see ESWL newsletter), SWL alone and open surgery. Complete removal of the stone is important in order to eradicate infection, relieve obstruction, prevent further stone growth, and preserve kidney function. Over time, an untreated staghorn calculus is likely to destroy the kidney and/or cause life-threatening infections (sepsis). If a staghorn stone is not treated, then renal deterioration occurs in at least 1 out of 4 patients. RecommendationsĪ patient with a staghorn stone should be treated. If a staghorn stone occurs in association with infection, there may be a pattern of intermittent and recurrent infection which may persist until the staghorn stone is removed. Some of the risk factors for staghorn stone formation include long standing history of stones, certain unique metabolic defects, and repeated urinary tract infections with particular types of bacteria. Staghorn stones form in the renal pelvis. In men, the urethra is longer and encircled by the prostate which is a gland that is part of the reproductive system. The urinary system is the same in both men and women from the kidneys to the bladder. The bladder stores urine until full and then empties to the outside through the urethra. Urine is constantly being made by the kidneys and transported through the ureters into the bladder. Urine travels through a tube on each side, the ureter, down to the bladder. Urine, once formed in the kidneys, is collected in the renal pelvis, the first part of the urinary drainage system. They filter the blood to extract excess waste products and fluid to form the urine. The kidneys, one on each side, sit high in the upper abdomen partially underneath the rib cage.
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