![]() They are most often composed of struvite (magnesium ammonium phosphate) and/or calcium carbonate apatite. Staghorn calculi refer to branched stones that fill all or part of the renal pelvis and branch into several or all of the calyces. In essence, antibiotics cannot clear the associated infection unless the stone material is completely removed. This stone matrix is believed to protect the bacteria from antibiotics. The infection stones generally grow rapidly and serve as the nidus (or center) for further stone formation. The alkaline urine leads to precipitation of magnesium ammonium phosphate crystals mixed with varying proportions of carbonate apatite. Urease hydrolyzes (or splits) urea into ammonium and hydroxyl ions resulting in an increase in ammonium and phosphate concentrations leading to an alkaline urine. These stones are associated with urinary tract infections caused by bacteria that produce urease. Approximately 75% of staghorn calculi are struvite (composed of magnesium, ammonium, phosphate crystals mixed with carbonate-apatite). ![]() Staghorn stones are stones that involve the renal pelvis and extend into at least 2 calyces of the kidney. Open surgery for kidney stones is strongly discouraged and reserved for only very rare cases with a very large stone burden or very unusual anatomy. ![]() The most effective treatment option is percutaneous nephrolithotomy, where the urologist inserts a scope directly into the kidney via a 1/2 inch tract made in your flank. Staghorn stones are large, branched stones occupying a large volume of the kidneys. Most staghorn stones in Western society are composed of struvite and can cause significant morbidity and mortality if left untreated therefore, large struvite stones must typically be removed. Staghorn calculi represent a less-common nephrolithiasis subgroup so named because the significant stone burden that fills the renal pelvis and calyces forms a shape on radiographs that resembles a deer’s horns. If the procedure is performed by an experienced surgeon, the complication rate is usually low.Learn all about staghorn calculus definition, symptoms, causes and treatment. The patient usually has to stay in hospital for three to five days. To finish off the operation, a catheter is inserted into the kidney (urinary diversion outwards via the flank) or a ureteral stent (internal diversion) is put in to prevent any obstruction of the urine flow. Once the endoscope – which can be as thick as a pencil – has been inserted into the kidney, the stone can be broken up with an ultrasonic or laser probe and the pieces can then be removed. The puncture procedure is carried out under visual control using ultrasound and X-ray imaging. This allows the surgery itself to be performed on the back. The patient is then moved onto their stomach so that they are lying face down. The urinary tract is prepared for the operation with the patient in the lithotomy position. This operation is generally performed under general anesthetic. This allows an endoscope to be inserted into the renal collecting system, where the stone is located. To do this, the kidney is punctured from the flank directly through the skin. Percutaneous nephrolitholapaxy (PCNL) involves removing kidney stones by creating an artificial opening in the back. A staghorn calculus is a stone that fills large sections of the renal pelvis or one or more of the renal calyces. This procedure is usually only carried out in the case of large and complex kidney stones, such as staghorn calculi.
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