[Treatment of staghorn calculi: combined therapy and stone recurrence]

Between April 1986 and September 1992, 29 extensive staghorn calculi were treated in 24 patients. Treatment was with extracorporeal shock-wave lithotripsy (ESWL) monotherapy in 11, initial ESWL followed by percutaneous nephrolithotomy (PNL) in 7 and initial PNL followed by ESWL in 11. A comparison based on treatment demonstrated that initial PNL followed by ESWL resulted in a lower rate and shorter duration of the "stone street" while stone-free rate at 1 year after the last treatment, recurrence rate, residual stone-growth rate and other complication rates were similar. Initial PNL followed by ESWL should be considered the efficacious treatment option, especially for patients with extensive traghorn calculi.