Staghorn calculus: the place of nephrolithotomy

Out of 190 staghorn calculi submitted to conservative surgical treatment, 20 were selected for deliberate nephrolithotomy on the basis of previous stone surgery, shape of stone or of kidney pelvis. Stone clearance was achieved in 80% of the cases. 1 patient died of pulmonary embolus; a massive secondary hemorrhage was successfully treated by transcatheter arterial embolization. Marked loss of renal function occurred three times on previously heavily scarred kidneys. Nephrolithotomy should be considered only when local conditions preclude extended pyelocalicotomy.