Staghorn Calculi: Controversies in Management

Abstract

Staghorn calculi may be defined as urinary stones occupying the renal pelvis and one or more infundibulae, with or without extension into the calyces. Partial staghorn calculi are those stones occupying one or two infundibulae, and complete staghorn calculi are those stones that totally fill the intrarenal collecting system. Variations of this definition also exist in that a seemingly large single stone may consist of multiple smaller ones. At times, the infundibula and calyces can be filled and the central renal pelvis will, paradoxically, be stone-free. These large stones can be of various compositions; they can occupy relatively-normal intrarenal collecting systems or be found in markedly dilated and distorted systems. Their presence may be associated with much intrarenal scarring, urinary tract infections, and will often have a related metabolic disorder associated with their formation. If untreated, these stones will usually result in attrition of renal function secondary to chronic obstruction and/or infection.