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Case Reports
. 2015 Oct 1;1(1):21-3.
doi: 10.1089/cren.2015.29003.jdc. eCollection 2015.

Medical Treatment of a Staghorn Calculus: The Ultimate Noninvasive Therapy

Joshua D Chamberlin  1 , Ralph V Clayman  1
Affiliations
Case Reports

Medical Treatment of a Staghorn Calculus: The Ultimate Noninvasive Therapy

Joshua D Chamberlin et al. J Endourol Case Rep. .

Abstract

A 77-year-old female presented with bilateral staghorn calculi. She underwent an uneventful left percutaneous nephrolithotomy (PCNL); the stone analysis revealed a 90% struvite and 10% calcium phosphate stone. Treatment of the right stone was postponed by the patient. During the next 9 months, her family physician gave her multiple courses of culture-directed antibiotics due to breakthrough urinary-tract infections, despite her also being on a prophylactic antibiotic. After 9 months, she agreed to undergo her right PCNL. Preoperatively, a non-contrast CT scan was obtained; it revealed complete resolution of the right staghorn calculi.

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Figures

<b>FIG. 1.</b>
FIG. 1.
CT scan prior to left PCNL: Bilateral staghorn stones, left 3.2 cm renal staghorn involving 3 calyces, HU of 694, and right 3.4 cm renal staghorn involving 3 calyces, HU of 664. There is mild left hydronephrosis, bilateral parenchymal thinning and two left renal parenchymal calcifications (not shown).
<b>FIG. 2.</b>
FIG. 2.
CT scan after 9 months of antibiotic therapy: No new left renal stones, improvement of left hydronephrosis and complete resolution of right renal stone.
See this image and copyright information in PMC

References

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    1. Flannigan R, Choy WH, Chew B, et al. . Renal struvite stones—Pathogenesis, microbiology, and management strategies. Nat Rev Urol 2014;11:333–341 - PubMed
    1. Türk C, Petřík A, Sarica K, et al. EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. Eur Urol 2015; [Epub ahead of print]; DOI: 10.1016/j.eururo.2015.07.040 - DOI - PubMed

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