Is it truly necessary to achieve complete stone-free status in cases of staghorn calculi?

To evaluate long-term outcomes in staghorn stone patients with residual fragments following surgical treatment.

A retrospective study of patients who underwent percutaneous nephrolithotripsy for staghorn stones and long term follow up were divided into two groups: residual stones versus non-residual stones. The occurrence of new stones or fragment growth, infectious events, and renal function were evaluated. Patients with a follow-up period of less than one year were excluded.

A total of 87 patients (75.9% female) were included in the study. Of these, 21.8% were stone-free, while 78.2% exhibited residual fragments with a median size of 7mm (3.5-11.5mm). The average follow-up period was 27 months (21-36 months). Only 24.1% experienced recurrence or growth of residual fragments, with a median growth of 10mm (6-12mm). Additionally, 14.9% of patients developed urinary infections during the follow-up period. No significant differences were observed between stone-free patients and those with residual fragments in terms of recurrence, residual fragments growth, infectious events, or deterioration in renal function. Similarly, no differences were noted when comparing patients with positive or negative cultures.

The incidence of recurrence, growth of residual fragments, infectious events, and deterioration of renal function was comparable between patients with and without residual stones. Furthermore, the presence of positive preoperative or intraoperative cultures did not influence these outcomes.