Staghorn Nephrolithiasis Research Articles

Современный подход к ведению пациентов с коралловидным нефролитиазом. Обзор литературы. Часть 2

Data on predictors and methods for resolving the complications of surgical treatment of staghorn nephrolithiasis are presented. New information on the features of the morphological and functional state and individual platelet reactivity in patients undergoing surgical treatment is described. Thrombotic and hemorrhagic complications, intra- and postoperative bleeding, as well as prediction of PNL results in patients with staghorn stones are also discussed.

Treatment of bilateral staghorn nephrolithiasis using percutaneous nephrolithotripsy in a patient chronically infected with Proteus mirabilis: a case report with literature review

Although urolithiasis is a common disease in the European population, bilateral staghorn stones are a relatively rare variant of nephrolithiasis. It is often associated with a chronic urinary tract infection or a metabolic disorder. The aim of this paper is to show an example of the treatment of bilateral staghorn stones in a patient chronically infected with a resistant strain of Proteus mirabilis. Percutaneous nephrolithotripsy (PCNL) is currently the gold standard of treatment. And this is the way the patient was managed. In the following section, the authors sought to describe new reports on this treatment method and how it could be improved. Conservative treatment does not appear to be a safe alternative. And of the other surgical treatments, PCNL has the greatest benefits. Nearly 68% of patients with bilateral staghorn stones have some underlying metabolic disorder in a small sample of patients. It seems reasonable, therefore, to introduce genetic and metabolic diagnosis in younger patients with the aim of prevention through diet or pharmacotherapy.

The influence of traditional nutrition on the parameters of urine pH-metry in the metaphylaxis of staghorn nephrolithiasis in patients living in the Kyrgyz Republic

The influence of traditional nutrition on the parameters of urine pH-metry in the metaphylaxis of staghorn nephrolithiasis in patients living in the Kyrgyz Republic

Modern possibilities of interventional radiology in the elimination of percutaneous nephrolithiasis surgery hemorrhagic complications

Рurpose. To increase the treatment eff ectiveness of patients with various forms of nephrolithiasis based on the development and integration of interdisciplinary approaches to the choice of surgical access. Materials and methods. The study was based on clinical and laboratory data and the results of surgical treatment of 133 patients with various forms of urolithiasis. Results. The analysis of complications of percutaneous surgery is shown by the example of 133 patients with various forms of nephrolithiasis, who underwent PCNL (percutaneous nephrolithotomy). The inclusion of highly informative methods of visualization of urinary stones, multispiral computed tomography with 3D-visualization and densitometry namely in the algorithm of examination of patients with nephrolithiasis is justifi ed. The possibilities of interventional radiology in the elimination of hemorrhagic complications of percutaneous surgery of urolithiasis, including staghorn nephrolithiasis, are presented. Conclusion. The eff ectiveness of the creation of multidisciplinary surgical teams, including specialists in the fi eld of interventional radiology, for the interpretation of diagnostic results, as well as the prevention and elimination of intra- and postoperative hemorrhagic complications, is proven.

Comparative Analysis of the Efficacy and Safety of Combined Pneumatic and Ultrasonic Lithotripsy in the Treatment of Patients with Staghorn Nephrolithiasis

Urolithiasis is one of the most common disease encountered in the daily practice of a urologist. Depending on the severity of the course, patients with urolithiasis and, in particular, kidney stones, are often required to have the surgical treatment. The greater problem is deemed to be staghorn nephrolithiasis and the choice of the optimal surgical technique for the elimination of kidney stones. The objective: to evaluate the efficacy and safety of the combined method of fragmentation of coral kidney stones in comparison with standard ultrasound lithotripsy. Materials and methods. A total of 352 percutaneous nephrolithotripsies (PCNL) were performed: 187 (53,1%) – patients who were diagnosed with staghorn calculi. The age of the patients ranged from 26 to 66 (mean age 42,5 years). There were 89 men and 98 women. 78 (41.7%) patients had previously undergone surgical treatment (open surgery or PCNL) of kidney stones, in which recurrent staghorn stones were subsequently identified. Nine (4,8%) patients had bilateral coral calculi. The size of the stone varied from 3,5 to 11,0 cm. Their density ranged from 300 to 1500 Hounsfield units. The most frequent complication of the underlying disease was chronic pyelonephritis – 145 (77,5%) patients. Hydronephrosis on the affected side was diagnosed in 98 (52,4%) patients. A combined pneumatic and ultrasonic lithotripter ShockPulse-SE from Olympus (Japan) was used for breaking kidney stones. We performed PCNL in a combined mode in 41 (21,9%) patients with staghorn nephrolithiasis. Results. In the group of patients using combined pneumatic and ultrasonic lithotripsy, complete removal of the staghorn calculus was achieved in 97,6% of cases (in 40 of 41 patients), whereas in the opposite group, using an ultrasonic lithotripter only in 84,9% (in 124 of 146 patients). The duration of the PCNL operation using the ShockPulse-SE device was from 35 to 130 minutes, on average – 48±5 minutes. The duration of the surgical intervention using an ultrasound lithotripter is from 90 to 180 minutes, an average –105±7 minutes. Blood loss during PCNL using an ultrasonic lithotripter was 200–400 ml, whereas with the ShockPulse-SE apparatus – 100–200 ml. An exacerbation of pyelonephritis was noted in 7 patients (in two patients after PCNL in a combined mode and in five after PCNL using an ultrasonic lithotripter). The mean length of patient hospitalization after surgery ranged from 4 to 10 days. At the same time, the average duration after PCNL using the combined ShockPulse-SE technique was 4±1 days, while after PCNL using an ultrasonic lithotripter it was 6±1 days. Conclusions. The combined technique of lithotripsy with a combined probe for simultaneous pneumatic and ultrasound lithotripsy has shown better results in terms of safety and efficacy compared to using only an ultrasound lithotripter. Used for decades, ultrasound lithotripsy for staghorn stone PCNL is both effective and safe moreover it’s a traditional technique. Thus, in comparison with ultrasound lithotripsy, the combined technique showed a shorter operation time, with less blood loss, a shorter length of patient hospitalization and less pyelonephritis in the postoperative period, as a result of maintaining a lower intrarenal pressure gradient during the operation. At the same time, the cost of the procedure using a combined probe was estimated, which turned out to be higher than traditional ultrasound lithotripsy. The use of combined lithotripsy with simultaneous aspiration of stone fragments is an indisputable advantage of this kind of PCNL in patients with staghorn nephrolithiasis, which brings the effectiveness of this technique closer to 100%.

Xanthogranulomatous Pyelonephritis: A Clinical Analysis

Xanthogranulomatous pyelonephritis (XGP) is an inflammatory form of chronic renal disease with the characteristics of pyelonephritis. It is associated with staghorn nephrolithiasis, kidney tissue damage, renal function loss, and a nonfunctional kidney. XGP can be confused with neoplastic or inflammatory renal conditions due to its indistinguishable imaging and its vague clinical presentation. The treatment of choice is nephrectomy. Only a few cases of XGP have been treated medically. XGP should be managed by urology and nephrology providers. The nurse practitioner should refer patients with recurrent or persistent urinary tract infections, renal stones, staghorn calculi, or pyelonephritis to nephrology and urology specialists for further evaluation and management.

Modern methods of surgical treatment of staghorn nephrolithiasis

Staghorn nephrolithiasis is a form of urolithiasis characterized by kidney stones formation that partially or completely fills the collecting system. Staghorn nephrolithiasis has a malignant course, accompanied by collecting system retention and impaired renal function. This pathology is a common cause of disability, which is particularly importance in the context of its prevalence among people of working age. The review systematizes the currently relevant data on surgery of staghorn nephrolithiasis, presents methods of surgical treatment, defines the selection options within them, their advantages and disadvantages, indications, contraindications and complications. This information can help in making an informed decision and increase the effectiveness of treatment for patients with that disease. At the moment, there is an arsenal of treatment options for staghorn nephrolithiasis, among them minimally invasive high-tech operations are the most advanced and recognized as the methods of choice. The modernization of existing technologies increases their efficiency and safety, but their high cost and the impossibility of using in some cases often make one prefer more traumatic radical interventions. Traditional surgery remains a reliable method of treatment, allowing simultaneous operations and treatment of complex cases of the disease. The possibility of combining existing methods allows for the effective removal of staghorn stones in different groups of patients. Thus, a careful and differentiated approach to the methods of surgical treatment of staghorn nephrolithiasis, their use in combination allows ensuring high efficiency of surgical treatment of this pathology.

Frequency and risk factors for antegrade ureteral stone migration after percutaneous nephrolithotomy.

IntroductionPercutaneous nephrolithotomy (PCNL) is the minimally invasive procedure of choice for the treatment of large and/or complex nephrolithiasis. Migration of residual fragments (RFs) into the ureter after PCNL is presumed to be uncommon. However, should associated stone-related events (SREs) occur, ancillary procedures may be required. The objective of this study was to describe the frequency and to analyze predictors of antegrade migration of RFs after PCNL.Material and methodsA case-control study of patients who underwent PCNL for nephrolithiasis and had a postoperative computed tomography available within 48 hours was performed. Descriptive statistics and logistic regression analysis were carried out.ResultsThe final sample included 169 interventions. Mean age was 49 ±13 years, median maximum stone size was 26 (7 to 87) mm and mean stone density was 835 (70 to 2022) Hounsfield Units (HUs). 7.1% of the patients experienced migration of RFs into the ureter after PCNL, of whom 41.6% suffered SREs. Lithotripsy was performed using ultrasonic (67.5%), laser (23.7%), and pneumatic (14.8%) technologies. Univariate analysis found female gender (OR 4.1, p = 0.02) height ≥1.68 m (OR 5.52, p = 0.009), middle (OR 6.71, p = 0.01) and upper (OR 3.59, p = 0.04) caliceal location, staghorn calculi (OR 4.72, p = 0.02), stone area (OR 1.001, p = 0.03), lasertripsy (OR 3.61, p = 0.03) and operative time (OR 1.007, p = 0.02) statistically significant for migration of SFs into the ureter after PCNL. Of these, only height ≥1.68 m (OR 7.17, p = 0.01) and staghorn nephrolithiasis (OR 13.27, p = 0.02) remained independent predictors in the multivariate analysis with an area under the curve of 0.69.Conclusions71.% of patients undergoing PCNL had a SF migrating to the ureter. Of these 41% suffered a SRE that required ancilliary interventions. Staghorn nephrolithiasis and ≥1.68 mts of height were found to predict this event.

Number of Metabolic Syndrome Components Is the Central Predictor of the Impact of Metabolic Syndrome on Outcome of Percutaneous Nephrolithotomy in Staghorn Nephrolithiasis.

Introduction: How to quantify the impact of metabolic syndrome (MetS) on percutaneous nephrolithotomy (PCNL) is unclear. We aimed to evaluate the quantified effect of the number of MetS components on the outcome of PCNL.Materials and Methods: In this retrospective cohort study, consecutive 606 patients with idiopathic staghorn renal stones undergoing PCNL were included. The participants were divided into two groups: MetS(+) and MetS(−). The number of MetS components were calculated as 0 to 5. Primary outcomes were stone-free rate (SFR) and overall complication rate.Results: MetS, obesity, hypertension, increased triglycerides (TG), decreased high-density lipoprotein cholesterol (HDL), and diabetes mellitus were found in 24.1%, 38.1%, 70.0%, 29.9%, 34.5%, and 26.4% of the patients, respectively. SFR values were comparable between groups. MetS resulted in a higher rate of overall complication (p < 0.001, odds ratio [OR] = 2.4, 95% confidence interval [CI] 1.67–3.69), blood transfusion, urosepsis, larger hemoglobin deficiency, and length of hospital stay. Multivariable analysis confirmed that fasting plasma glucose (FPG) (p = 0.033, OR = 1.164, 95% CI 10.22–1.348) and number of MetS components (p = 0.001, OR = 1.496, 95% CI 1.184–1.890) were independent risk factors, whereas HDL (p = 0.014, OR = 0.428, 95% CI 0.217–0.837) played an independent protective role. Compared with 0, having 3, 4, and 5 MetS components was associated with stepwise increase in complication rate (19.5% vs 34.2%, 41.5%, 62.5%, p = 0.027, 0.006, <0.001; OR = 2.1, 2.9, 6.9). Subgroup analysis showed that MetS(+) patients without complications were associated with lower systolic blood pressure, TG, and FPG (p = 0.010, 0.031, 0.002, respectively).Conclusions: The number of MetS components is the central predictor in assessing both inner severity of MetS and outer risk for PCNL. The number of MetS components is recommended to be calculated on a scale of 0 to 5. Three, four, and five MetS components increase risk for PCNL in a stepwise manner regardless of the presence or absence of obesity. MetS components should be controlled preoperatively.

A case of open surgical treatment of staghorn calculus in a patient with factor VII deficiency

The paper presents a clinical case of treatment of staghorn nephrolithiasis complicated in the postoperative period by bleeding caused by a latent deficiency of factor VII of the blood coagulation system. Often the disease is latent and is detected in serious injuries or during the surgeries. Sometimes the diagnosis is made in profuse bleeding. Under endotracheal anesthesia, the left-sided nephrolithotomy and intrarenal stenting with clamping of the renal artery was performed. The time of clamping of the renal artery was 12 minutes. Before clamping the renal artery, 3 mg of furosemide 0.2 mg of verapamil and 1 mg of methylethylpiridinol were introduced intravenously per kilogram of patient' weight. A stone sized 3.02.5 cm was removed from the kidney, and a number of small stones were washed out from the lower group of calyces. At the time of diagnosis, prothrombin time and prothrombin index were checked. The patient's hemostasis system, including clotting factors, were examined. The results showed that the patient's blood clotting time by LeeWhite method increased to 15 minutes (reference, 713 minutes), and the time of activated partial thromboplastin time (aPTT) to 41.6 seconds (reference, 2838 seconds), while the activity of factor VII decreased to 40% (reference, 70120%). After that, the patient was diagnosed with factor VII deficiency or hypoproconvertinemia. During treatment, the patient was transfused twice a day with fresh frozen plasma and only once during the entire period, 1000 IU of antiinhibitoty coagulant complex (FEIBA) was administered intravenously. From the first day of treatment hematuria decreased, there was a reverse development of hemorrhagic syndrome. Obvious and latent comorbidities before and after the surgery should not be left out without attention. Only in this case it is possible to successfully complete the treatment and achieve the correct results.

Stages of development of surgical treatment of staghorn nephrolithiasis

Проанализированы результаты лечения пациентов Коралловидных нефролитиазом за период с 1974 по 2015 года. Особое внимание уделялось больным с Коралловидных нефролитиазом в стадии К4, что составило 1907 человек. Анализе разделены на три периода: 1974-1991 гг. - период традиционных оперативных вмешательств с традиционным разрезом в области почек 1991-2006 гг. - с за- применением дистанционной литотрипсии; 2006- 2015 гг. - период малоинвазивных вмешательств. Все больные подвергались тщательному общеклиническое обследование, ультразвуковом и радионуклидном исследованиям, обзорной и экскреторной урографии, а также спиральной компьютерной томографии. Контактная литотрипсия выполнялась с использованием поверхностно веществ (ПАВ) в положении на животе. Использование поверхностно-активные вещества при контактной литотрипсии позволило сократить время дезагрегации камня в 1,5-2 раза. Для малоинвазивных вмешательств использовалась аппаратура Karl Storz R. Wolf. Эндоскопическая дилатация пунк-ции фистулы позволяет с минимальными потерями получить доступ к коралловидных камней. Наши исследования показали преимущество современных малоинвазивных методов лечения, что подтверждается сокращением периода стационарного лечения. На сегодняшний день эффективность эндоурологических лечения больших и коралопо-дибних камней в нашей клинике достигла 92%. Используемая медикаментозная периоперационная ренопротекторного интенсивная терапия позволяет облегчить период восстановления функции оперированной почки. Медикаментозная ренопротекторного терапия на всех этапах лечения больных направлена на профилактику реперфузионных повреждений, улучшение условий кровообращения в системе микроциркуляции ишемизированной почки, уменьшение выраженности экссудативного и воспалительного процесса, что позволило сократить количество гемотрансфузий при решении проблем Коралловидных нефролитиаза.

Clinical application of dedicated ultrasound guided standard channel combined with the one-stage mini-PCNL in the treatment of staghorn nephrolithiasis

Objective To compare the efficacy and safety of standard access combined with minimally access percutaneous nephrolithotomy(mini-PCNL) and one-stage multi-channel mini-PCNL in the treatment of staghorn nephrolithiasis. Methods From August 2015 to December 2017, we prospectively collected 86 cases of the staghorn nephrolithiasis treated by multi-channel percutaneous nephrolithotomy underwent dedicated ultrasound guided.All patients were randomly divided into two groups[group of the standard channel combined with the one-stage mini-PCNL(40 cases), mini-PCNL group(46 cases)]. The operative time, number of channels, stone clearance rate, hemoglobin decline, adjuvant therapy and complication rate were summarized. Results Eighty-six patients were successfully established a multichannel, and the success of gravel stone.There was no significant difference in sex, age, stone load and preoperative complications between the two groups (P>0.05). The operation time of the combined channel group was(68.23±11.06)min, the mini-PCNL group was (82.83±9.09)min (P 0.05). The hospitalization days were(6.00±1.59) day and (7.89±2.11)day (P<0.01). The postoperative fever rate was 5.00% and 19.57%, respectively (P<0.05). There was no significant difference in the number of auxiliary treatment of one-stage postoperative, the number of channels and the removal rate of stone. Conclusions A multi-channel PCNL technique is used to treat the staghorn nephrolithotomy under the guidance of special urology ultrasound probe guide, puncture path the kidney dome, the group of standard channel combined with the one-stage had shorter time in operation and hospitalization, with lower intraoperative renal pelvic pressure, increases high the rate of the one-stage removal of stones, doesn't increase the number of channels and complications.So it is safe and reliable, worthy of clinical use. Key words: Kidney Calculi; Nephrostomy, Percutaneous; Ultrasonography

The results of open surgical treatment of bilateral staghorn and multiple nephrolithiasis

Aim. To determine the status and to increase the effectiveness of open surgical treatment of bilateral staghorn nephrolithiasis.&#x0D; Methods. We studied the results of surgical treatment of 250 patients who underwent open surgery for severe forms of bilateral staghorn nephrolithiasis. The patients were divided into four groups according to the features of changes in both kidneys and ureters - group 1 included 125 (50.0%) patients with bilateral staghorn nephrolithiasis, group 2 - 35 (14.0%) patients with staghorn nephrolithiasis of solitary or the only functioning kidney, 70 (28.0%) patients with unilateral staghorn nephrolithiasis and solitary or multiple kidney or ureter stones on the other side were included into group 3, and group 4 inlcuded 20 (8.0%) patients with unilateral staghorn nephrolithiasis and nonobstructive hydronephrosis and other diseases on the other side. The age of patients ranged from 7 to 76 years old, ranging among children from 7 to 18 years (average age 12.1±0.4 years) and among adults from 19 to 76 years (average age 46.4±0.6 years). Among patients, 121 (48.4%) were males and 129 (51.6%) were females.&#x0D; Results. Surgical tactics and the results of performed surgeries in certain groups were studied. Overall, 127 (50.8±3.8%) of 250 patients underwent surgery on the right kidney, and 123 (49.2±3.2%) - on the left kidney. To achieve minimal blood loss during the surgery, in 20% of cases renal artery was clamped. To protect kidneys from ischemia, 3 mg/kg of furosemide, 0.2 mg/kg of verapamil and 1 mg/kg of methylethylpiridinol were used before and after clamping of the renal artery. Open surgical treatment of 250 patients with bilateral staghorn nephrolithiasis was successful in 246 (98.4±0.8%) patients. In case of residual stones, extracorporeal or ureterorenoscopic shock wave lithotripsy was performed.&#x0D; Conclusion. Despite the wide application of modern endoscopic methods of therapy in the treatment of this group of patients, in complex forms of staghorn nephrolithiasis open surgery is more effective.

Пациент с коралловидным нефролитиазом и «забытым» стентом мочеточника: диагностика и лечение

Пациент с коралловидным нефролитиазом и «забытым» стентом мочеточника: диагностика и лечение

The scale for the evaluation of the renal parenchymal injury degree in patients with nephrolithiasis

Background. The absence of scale that allows us to assess the degree of renal parenchymal injury by renal calculi and traumatic impact of the surgical methods of treatment has made this research relevant. The purpose of the study was to improve the efficiency of renal parenchymal injury diagnosis and to optimize the surgical management of urolithiasis. Material and methods. For the period from 2014 to 2017, 158 patients with nephrolithiasis were examined. The level of cystatin C in the blood serum of patients with nephrolithiasis was determined by the enzyme immunoassay method in the preoperative period and in the first 48 hours after surgery. The test system BioVendor (Germany) was used. Patients were divided into five groups. Group I was formed of 31 patients, who underwent micropercutaneous nephrolithotripsy. The second group included 31 individuals, who underwent ultra-mini-percutaneous nephrolithotripsy. Group III consisted of 35 patients treated with standard percutaneous nephrolithotripsy. Group IV included 30 persons with staghorn calculi, in this group the combination of a single standard access with multiple ultra-mini-percutaneous access was used. Thirty one patients in group V underwent nephrolithotripsy using multiple standard accesses. Group VI (control) included 32 apparently healthy volunteers with normal serum cystatin C level. To determine the adequacy of the proposed scale of the degree of renal parenchyma injury distribution, Receiver Operating Characteristic curve analysis was applied. Statistical studies were performed using the Statistica 6.0 package. Results. A serum marker of renal parenchymal injury degree — cystatin C in patients with nephrolithiasis is proposed. Based on its assessment, it was proved that in patients with calculi up to 2 cm in diameter, micropercutaneous nephrolithotripsy and ultra-minipercutaneous nephrolithotripsy have a statistically identical degree of renal parenchymal injury. The above noted degree of renal injury was lesser in comparison to standard percutaneous access. In patients with staghorn calculi, according to the serum cystatin C level, percutaneous nephrolithotripsy with multiple standard accesses is the most traumatic endoscopic surgical intervention. The coefficient of renal parenchymal injury was developed, which is determined by the ratio of the difference in serum cystatin C levels (before and after the surgery) to the serum level of this biomarker before surgery. A scale of its use has been created that makes it possible to establish three degree of renal parenchymal injury: mild — with a coefficient of ≤ 0.15; average — from 0.15 to 0.35 and severe — more than 0.35. This scale allows us to assess the traumatic effect of renal calculi in patients with urolithiasis, the efficacy of applied surgical technique and the success of conservative therapy. Conclusions. Based on evaluation of the renal parenchymal injury biomarker (cystatin C) in patients with nephrolithiasis with calculi up to 2 cm in diameter, it was proved that micropercutaneous nephrolithotripsy and ultra-minipercutaneous nephrolithotripsy have statistically equal degree of renal parenchymal injury but lesser than with a standard technique. Regardless the diameter of the calculus, nephrolithotripsy using one standard access or combined application of one standard and multiple ultra-minipercutaneous accesses, according to the serum cystatin C levels, have the same traumatic impact on the renal parenchyma (p > 0.05). In patients with staghorn nephrolithiasis, according to the levels of cystatin C, percutaneous nephrolithotripsy using multiple standard access is the most traumatic endoscopic intervention. A scale for predicting the extent of renal parenchymal injury has been developed for various clinical forms of urolithiasis and methods of nephrolithotripsy.

Hemorrhagic complications of percutaneous interventions for nephrolithiasis

To investigate the incidence of hemorrhagic complications after percutaneous nephrolithotripsy. This was a comparative analysis of 146 percutaneous nephrolithotripsies. The study group comprised 81 patients with stag horn nephrolithiasis; the rest of the patients were assigned to the control group. Both groups were comparable in age and sex (p>0.05). The body weight of the patients in the study group was statistically significantly higher than in the control group, amounting to 94.1+/-15.4 and 68.3+/-9.6 kg, respectively (p<0.05), the body mass index in the study group averaged 45.9+/-7.6 kg/m2 versus 28.5+/-9.4 kg/m2 in the control group (p<0.05). 50.6% of the study group patients had urate urolithiasis. The blood loss depended on operative time and the number of accesses to the kidney. The incidence of hemorrhagic complications did not differ in both groups and was in the range of 16 to 16.9% (p> 0.05). Early hemorrhagic complications did not exceed Grade II, according to Clavien-Dindo classification. Anticoagulant and antiplatelet therapy did not increase the number of hemorrhagic complications. Arterial hypertension was the main risk factor for hemorrhagic complications. Arterial hypertension in patients scheduled for percutaneous nephrolithotripsy should be corrected. To stop ongoing renal bleeding, image-guided endovascular interventions should be used.

64 - Experience in the treatment of patients with Staghorn nephrolithiasis by the Department of Urology, Regional Urology Center of Nephrology and Dialysis

64 - Experience in the treatment of patients with Staghorn nephrolithiasis by the Department of Urology, Regional Urology Center of Nephrology and Dialysis

Large prostatic stones with staghorn renal calculus in a 61-year-old man: an unusual presentation of uncommon disease

Prostatic parenchymal calculi are common in ageing men who are evaluated for benign prostatic hyperplasia or prostate cancer. Giant prostatic calculi are very rare, usually associated with local predisposing factors...

Качество жизни больных с коралловидным нефролитиазом после проведенного лечения

Качество жизни больных с коралловидным нефролитиазом после проведенного лечения

E92 Surgical treatment of staghorn and multiple nephrolithiasis

E92 Surgical treatment of staghorn and multiple nephrolithiasis