Do staghorn kidney stones need to be removed?

Over time, an untreated staghorn calculus is likely to destroy the kidney and/or cause life-threatening infections (sepsis). Complete removal of the stone is important in order to eradicate infection, relieve obstruction, prevent further stone growth, and preserve kidney function.

What is a staghorn kidney stone?

Staghorn calculi are complex renal stones that occupy the majority of the renal collecting system. These stones are associated with high morbidity and can lead to recurrent urinary tract infections, urosepsis, renal deterioration, and death if left untreated. Managing patients with staghorn calculi can be challenging.

What causes staghorn calculus?

Staghorn calculi are most frequently composed of mixtures of magnesium ammonium phosphate (struvite) and calcium carbonate apatite; they are strongly associated with UTIs caused by organisms that produce the enzyme urease, which promotes the generation of ammonia and hydroxide from urea.

What is the most common cause of staghorn renal calculi?

Epidemiology. Staghorn calculi are the result of recurrent infection and are thus more commonly encountered in women 6, those with renal tract anomalies, reflux, spinal cord injuries, neurogenic bladder or ileal ureteral diversion.

What bacteria causes staghorn kidney stones?

Staghorn calculi are composed of struvite (chemically this is magnesium ammonium phosphate or MAP) and are usually seen in the setting of recurrent urinary tract infection with urease-producing bacteria (e.g. Proteus, Klebsiella, Pseudomonas and Enterobacter).

Do staghorn calculi cause pain?

Unlike other urinary stones that commonly produce symptoms (eg, renal colic) that necessitate intervention, treatment of struvite stones often occurs in patients without classic signs of nephrolithiasis; this is because large staghorn calculi may not cause acute renal or ureteral dilatation and resultant pain.

What are the symptoms of a staghorn kidney stone?

Symptoms may include flank pain classic for renal colic, fever, urinary symptoms (eg, frequency, dysuria), and hematuria (either gross or microscopic). However, struvite stones rarely manifest as a solitary ureteral stone with acute renal colic in the absence of prior intervention.

How common are staghorn calculi?

Although kidney stones are commoner in men, staghorn stones are less often reported in men compared to women and they are usually unilateral [4–8]. Staghorn stones are infection stones in 49–68% of cases and, therefore, the term staghorn traditionally referred to struvite stone [9,10].

Who gets staghorn calculi?

Are staghorn calculi painful?

The majority of staghorn calculi are symptomatic, presenting with fever, hematuria, flank pain and potentially septicemia and abscess formation.

How do you get rid of staghorn kidney stones?

Generally, the gold standard treatment for staghorn stones is surgical with a view to achieve stone-free collecting system and preserve renal function. Percutaneous nephrolithotomy should be the recommended first-line treatment for staghorn stones.

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