PriMera Scientific Medicine and Public Health (ISSN: 2833-5627)

Case Study

Volume 6 Issue 5

Management of Severe Infectious Complications in a Patient with Bilateral Staghorn Kidney Stones and Xanthogranulomatous Pyelonephritis: A Case Study

Flavia Liliana Turcu, Elena Cuiban*, Ileana Adela Vacaroiu, Mitrea Ana-Raluca and Baboi Daniel

May 03, 2025

DOI : 10.56831/PSMPH-06-210

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Abstract

Staghorn calculi are a serious therapeutical challenge in clinical practice.

They can determine multiple complications represented by persistent pain, haematuria, chronic kidney disease, and various types of urinary tract infections including the urinary sepsis.

The consequences of the associated infectious complications can vary from urinary tract infections and recurrent urinary tract infections to pyelonephritis, renal abscesses and even pyonephrosis with perirenal abscesses or xantogranulomatous pyelonephritis.

The case that will be presented shows that the treatment of the staghorn calculi with the associated infectious complications, especially if they determine secondary urosepsis, is not only complex, multimodal and multidisciplinary, but unfortunately sometimes major surgical options like nephrectomy could be necessary as a life-saving option.

Keywords: staghorn calculus; infectious complications; renal abscess; xanthogranulomatous pyelonephritis; nephrectomy

References

  1. Blandy JP and Singh M. “The case for a more aggressive approach to staghorn stones”. J Urol 115 (1976): 505-506.
  2. Teichman JM, Long RD and Hulbert JC. “Long-term renal fate and prognosis after staghorn calculus management”. J Urol 153 (1995): 1403-1407.
  3. Deutsch PG and Subramonian K. “Conservative management of staghorn calculi: a single-center experience”. BJU Int 118 (2016): 444-450.
  4. Diri A and Diri B. “Management of staghorn renal stones”. Ren Fail 40 (2018): 357-362.
  5. Clayman RV., et al. “Percutaneous nephrolithotomy. An approach to branched and staghorn renal calculi”. JAMA 250 (1983): 73-75.
  6. Chibber PJ. “Percutaneous nephrolithotomy for large and staghorn calculi”. J Endourol 7 (1993): 293-295.
  7. Meretyk S., et al. “Complete staghorn calculi: random prospective comparison between extracorporeal shock wave lithotripsy monotherapy and combined with percutaneous nephrostolithotomy”. J Urol 157 (1997): 780-786.
  8. Marguet CG., et al. “Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi”. BJU Int 96 (2005): 1097-1100.
  9. Landman J., et al. “Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy”. J Urol 169 (2003): 64-67.
  10. Gleeson MJ and Griffith DP. “Extracorporeal shockwave lithotripsy monotherapy for large renal calculi”. Br J Urol 64 (1989): 329-332.
  11. El-Assmy A., et al. “Extracorporeal shock-wave lithotripsy monotherapy of partial staghorn calculi. Prognostic factors and long-term results”. Scand J Urol Nephrol 40 (2006): 320-325.
  12. Streem SB, Yost A and Dolmatch B. “Combination “sandwich” therapy for extensive renal calculi in 100 consecutive patients: immediate, long-term and stratified results from a 10-year experience”. J Urol 158 (1997): 342-345.
  13. Smith M and Boyce WH. “Anatrophic nephrotomy and plastic calyrhaphy”. J Urol 99 (1968): 521-527.
  14. Tiselius HG., et al. “Minimally invasive treatment of infection staghorn stones with shock wave lithotripsy and chemolysis”. Scand J Urol Nephrol 33 (1999): 286-290.