[Combination therapy of ESWL and PNL for the staghorn calculi]

We have been engaged in the treatment of urinary tract calculi using extracorporeal shockwave lithotripsy (ESWL) and endourology techniques for more than 8 years. In the treatment of thin staghorn calculi, ESWL monotherapy is the first choice. On the other hand, combination of percutaneous nephrolithotomy (PNL) and ESWL is important for the treatment of thick staghorn calculi in order to avoid the stone street and side effects of shock waves. When the stone is made of hard components such as calcium oxalate monohydrate and cystine, combination of both methods is also useful. In the case of complicated staghorn calculi with isolated branches, open surgery such as nephrolithotomy or partial nephrectomy might be the choice.