International Urology and Nephrology

, Volume 26, Issue 3, pp 247–253 | Cite as

Open stone surgery: Is it still a preferable procedure in the management of staghorn calculi?

  • A. A. Esen
  • Z. Kirkali
  • C. Güler


We reviewed 43 patients with staghorn calculi to determine the effectiveness of various treatment modalities such as extracorporeal shock wave lithotripsy (ESWL) monotherapy, ESWL and percutaneous nephrolithotomy (PCNL) combined therapy, and open stone surgery.

While ESWL monotherapy and ESWL+PCNL were performed in 25 and 8 patients, respectively, 10 patients underwent open stone surgery. Of the 25 patients treated with ESWL, 8 were stone-free, whereas 4 out of 8 patients treated with ESWL+PCNL and 8 out of 10 patients treated with open surgery were stone-free. The complications of ESWL monotherapy consisted of pyelonephritis in one patient, and stone street formations in three. In the group of ESWL+PCNL, one patient developed pyonephrosis, and another perinephritic abscess. No serious complication was noted in patients who underwent open surgery, but an average of 525 ml of blood transfusion was required.

We conclude that open stone surgery, although invasive, is still beneficial in the treatment of staghorn calculi.


International Urology Extracorporeal Shock Wave Litholxip Stone Burden Staghorn Stone Staghorn Calculus 
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  1. 1.
    Bossche, M. V., Simon, J., Schulman, C. C.: Shocks wave monotherapy of staghorn calculi.Eur. Urol., 17, 1 (1990).Google Scholar
  2. 2.
    Schulze, H., Hertle, L., Kutta, A., Graff, J., Senge, T.: Critical evaluation of treatment of staghorn calculi by percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy.J. Urol., 141, 822 (1989).PubMedGoogle Scholar
  3. 3.
    Assimos, D. G., Wrenn, J. J., Harrison, L. H., McCullough, D. L., Boyce, W. H., Taylor, C. L., Zagoria, R. J., Dyer, R. B.: A comparison of anatrophic nephrolithotomy with and without extracorporeal shock wave lithotripsy for management of patients with staghorn calculi.J. Urol., 145, 710 (1991).PubMedGoogle Scholar
  4. 4.
    Gleeson, M., Lerner, S. P., Griffith, D. P.: Treatment of staghorn calculi with extracorporeal shock wave and percutaneous nephrolithotomy.Urology, 38, 145 (1991).PubMedCrossRefGoogle Scholar
  5. 5.
    Vandeursen, H., Baert, L.: Extracorporeal shock wave lithotripsy monotherapy for staghorn stones with the second generation lithotriptors.J. Urol., 143, 252 (1990).PubMedGoogle Scholar
  6. 6.
    Winfield, H. N., Clayman, R. V., Chaussy, C. G., Weyman, P. J., Fuchs, G. J., Lupu, A. N.: Monotherapy of staghorn renal calculi: A comparative study between percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy.J. Urol., 139, 895 (1988).PubMedGoogle Scholar
  7. 7.
    Assimos, D. G., Boyce, W. H., Harrison, L. H., McCullough, D. L., Kroovand, R. L., Sweat, K. R.: The role of open stone surgery since extracorporeal shock wave lithotripsy.J. Urol., 142, 263 (1989).PubMedGoogle Scholar
  8. 8.
    Koga, S., Arakaki, Y., Matsuoka, M., Ohyama, C.: Staghorn calculi—Long-term results of management.Br. J. Urol., 68, 122 (1991).PubMedCrossRefGoogle Scholar
  9. 9.
    Lingemann, J. E., Smith, L., Woods, J. R., Newman, D. M.: Urinary Calculi: ESWL, Endourology and Medical Therapy. Lea & Febiger, Philadelphia 1989, pp. 163–191.Google Scholar
  10. 10.
    Constantinides, C., Recker, F., Jaeger, P., Hauri, D.: Extracorporeal shock wave lithotripsy as monotherapy of staghorn renal calculi: 3 years of experience.J. Urol., 142, 1415 (1989).PubMedGoogle Scholar
  11. 11.
    Rao, P. N., Holden, D.: Management of staghorn stones using a combination of lithotripsy, percutaneous nephrolithotomy and solution R irrigation.Br. J. Urol., 167, 13 (1991).Google Scholar
  12. 12.
    Eisenberger, F.: Differentiated approach to staghorn calculi using extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. An analysis of 151 consecutive cases.World J. Urol., 5, 248 (1987).CrossRefGoogle Scholar
  13. 13.
    Sohn, M.: Anesthesia-free ESWL monotherapy with double J stents versus PCNL/ESWL combined approach in staghorn disease. A retrospective randomized study. In: Lingemann, J. E., Newman, D. M. (eds). Shock Wave Lithotripsy: State of the Art. Plenum Press, New York 1988, Chapter 18, pp. 95–100.Google Scholar
  14. 14.
    Fuchs, G. J., Fuchs, A. M., Royce, P. L., Stenzl, A., Chaussy, C. G.: Staghorn stone treatment with extracorporeal shock wave lithotripsy: The fate of residual stones. In: Lingemann, J. E., Newman, D. M. (eds): Shock Wave Lithotripsy State of the Art. Plenum Press, New York 1988, Chapter 19, pp. 101–104.Google Scholar

Copyright information

© Akadémiai Kiadó 1994

Authors and Affiliations

  • A. A. Esen
    • 1
  • Z. Kirkali
    • 1
  • C. Güler
    • 1
  1. 1.Department of UrologyDokuz Eylül University, School of MedicineIzmirTurkey

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