What You Need to Know About the Troublesome Staghorn Calculus

Staghorn kidney stones, or staghorn calculi, are large, branched stones that fill a significant portion of the renal collecting system. They are often associated with recurrent urinary tract infections caused by urease-producing bacteria such as Proteus, Klebsiella, or Pseudomonas. These bacteria increase urinary pH and promote struvite crystal formation, leading to rapid stone growth. Epidemiologically, staghorn stones are more common in women, likely due to the higher prevalence of urinary tract infections in this group. Although less frequent than smaller calcium oxalate stones, they present a higher risk to kidney function, and in severe untreated cases, may lead to kidney loss.

A key point in management is achieving a “stone-free” status. Leaving residual fragments, even small ones, significantly increases the chance of recurrence. Studies have shown that residual fragments can act as a nidus for new crystal formation and infection persistence, accelerating recurrence rates. Historically, treatment for staghorn stones was associated with high morbidity, often requiring open surgery. Today, the gold standard is combined endourological treatment, such as simultaneous flexible ureteroscopy and percutaneous nephrolithotomy, performed in a single session. This approach increases the likelihood of complete stone clearance while minimizing patient recovery time. In some complex cases, the combined approach may involve multiple percutaneous accesses or even staged procedures. The choice depends on stone size, anatomy, infection status, and patient comorbidities.

Postoperative follow-up is essential. Periodic imaging, urine culture monitoring, and metabolic evaluation help detect early recurrence. Prophylactic strategies, such as controlling urinary infections and correcting metabolic abnormalities, are critical to reducing recurrence risk. From a public health perspective, prevention and early treatment of urinary infections could significantly reduce the incidence of staghorn calculi.

For more information about the incidence, causes, and complete treatment strategies for these stones, you can visit our dedicated page on staghorn calculi. If you are seeking advanced options for the Tratamento de cálculo renal em Juiz de Fora, our center offers modern combined approaches with high success rates. For general information about our practice and philosophy of care, please visit our main homepage.