Does calcium contribute to the effectiveness of a coagulum for pyelolithotomy?

Adding calcium to a mixture of thrombin and fibrinogen increased the breaking strain of the resultant coagulum by 10-fold, but did not significantly reduce the length to which it could be stretched. There was no detectable change in the time taken for the coagulum to dissolve in urine. Simulation pyelolithotomies were performed on pig kidneys containing ball-bearings which represented calculi. Coagula formed with calcium were significantly more effective at retrieving the ball-bearings than coagula without calcium. It is concluded that the ideal coagulum formula should include 1 mmol of calcium.