Definition, treatment and outcome of residual fragments in staghorn stones.

Technological advances in minimally invasive treatment of stone disease and its integration with concomitant clinical practice are amongst the most important achievements in urology. Despite the wealth of information accumulated over the years and the richness of existing literature, the knowledge about the definition, treatment and outcomes of residual stone fragments after percutaneous nephrolithotomy (PNL) is still insufficient. Due to the high stone load a lot of patients with staghorn stones have residual fragments (RFs) after treatment with PNL, which depends on the size of tract, definition of stone free rate (SFR), timing of evaluation and the imaging used. No consensus exists on the imaging modality or their timing in the evaluation of possible RFs. The treatment of residual stones is apparently different depending on the facilities of the department and the preference of the surgeon, which includes active surveillance, shock wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS) or a second look PNL.

Asian journal of urology. 2019 Dec 31 [Epub]

Osman Ermis, Bhaskar Somani, Thomas Reeves, Selcuk Guven, Pilar Laguna Pes, Arun Chawla, Padmaraj Hegde, Jean de la Rosette

Istanbul Medipol University, School of Medicine, Department of Urology, Istanbul, Turkey., University Hospital Southampton NHS Trust, Department of Urology, Southampton, UK., Kasturba Medical College, Manipal Academy of Higher Education, Department of Urology, Manipal, India.