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Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

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Same author

Percutaneous nephrolithotomy: wisdom, dogma, paradigm and myths surrounding puncture.

BJU international·2025
Same author

International Alliance of Urolithiasis (IAU) guideline on staghorn calculi management.

World journal of urology·2024
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High-frequency shock wave lithotripsy: stone comminution and evaluation of renal parenchyma injury in a porcine ex-vivo model.

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Percutaneous nephrolithotomy - the puncture.

BJU international·2021
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<i>Editorial Comment on:</i> Current Educational Interventions for Improving Technical Skills of Urology Trainees in Endourologic Procedures: A Systematic Review by Aditya et al. (J Endourol [Epub ahead of print]; DOI: 10.1089/end.2019.0693).

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Is supermini-percutaneous nephrolithotomy a new way forward?

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Related Experiment Video

Updated: Mar 11, 2026

A Modified Mirror Test as a Visual Guide for the Self-awareness Trait in Wild Antarctica Penguins, Pygoscelis adeliae
04:51

A Modified Mirror Test as a Visual Guide for the Self-awareness Trait in Wild Antarctica Penguins, Pygoscelis adeliae

Published on: July 8, 2025

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Heart of Darkness.

Peter Alken1

  • 1Department of Urology, Mannheim University Hospital , Mannheim, Germany .

Journal of Endourology Case Reports
|November 22, 2016
PubMed
Summary

Percutaneous nephrolithotomy (PCNL) can lead to severe complications, even death, particularly in complex cases. This case highlights the critical need to consider alternative treatments for staghorn calculi.

Area of Science:

  • Nephrology
  • Surgical Outcomes
  • Medical Ethics

Background:

  • Percutaneous nephrolithotomy (PCNL) is a common procedure for kidney stone removal.
  • Complex cases, such as bilateral staghorn calculi, present significant surgical challenges.
  • Patient outcomes in complex PCNL cases require careful consideration.

Observation:

  • A 37-year-old woman with bilateral staghorn calculi underwent PCNL.
  • The patient experienced a fatal outcome following the procedure.
  • This case elicits profound emotional responses, comparable to significant personal loss.

Findings:

  • PCNL in patients with extensive bilateral staghorn calculi carries a high-risk profile.
  • The presented case resulted in a fatal complication.
Keywords:
Heart of DarknessJoseph Conradmortalitypercutaneous nephrolithotomy

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  • Emotional impact on the surgical team is a significant factor in managing adverse events.

    • Implications:

    • Alternative treatment strategies should be rigorously evaluated for complex staghorn calculi.
    • Enhanced patient selection and risk stratification are crucial for PCNL.
    • The psychological impact of surgical complications on clinicians warrants attention and support.