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World J Urol 2019 Apr 9. Epub 2019 Apr 9.

Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, No.168, Changhai Rd, Shanghai, 200433, China.

Purpose: To describe the clinical characteristics of struvite stones and determine the preoperative predictors of sepsis in struvite patients undergoing percutaneous nephrolithotomy (PCNL).

Methods: A retrospective study of patients who underwent PCNL between April 2011 and March 2018 was performed. The data of the struvite stones and non-struvite stones groups were compared following propensity score matching. Read More

J Tradit Complement Med 2019 Jan 2;9(1):24-37. Epub 2018 Mar 2.

Department of Pharmacology, Al Shifa College of Pharmacy, Poonthavanam Post, Kizhattur Village, Perinthalmanna, Malappuram Dist, Kerala, India.

(L.) is a traditional herb, commonly used for the treatment of kidney stone related problems. Struvite stone can swiftly grow and become 'staghorn calculi' in kidney and its associated areas, which is the most aching urological disorder. Read More

World J Urol 2018 Sep 25. Epub 2018 Sep 25.

Department of Urology, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, No. 168 Litang Road, Changping District, Beijing, 102218, China.

Purpose: To report our experience with total ultrasound-guided percutaneous nephrolithotomy (PCNL) in the management of patients with solitary kidney, and evaluate the safety and feasibility of this technique.

Materials And Methods: Between October 2014 and December 2016, 48 patients with solitary kidneys underwent total ultrasound-guided PCNL at our institution. Stone-free rate (SFR), auxiliary procedures, and complications were recorded. Read More

Recent Pat Drug Deliv Formul 2018 ;12(3):170-178

Department of Chemistry, School of Advanced Sciences, VIT University, Vellore-632014, India.

Background: Herbal drugs are gaining exponential scientific recognition due to their distinct advantages. In the last 2-3 decades, a gradual increase in worldwide patents on herbal nanoformulations has been noted to address the solubility and bioavailability issues of phytoceuticals. Struvite or ammonium magnesium phosphate hexahydrate (NH4MgPO4. Read More

Indian J Urol 2018 Apr-Jun;34(2):144-148

Department of Sugery, S.P. Medical College, Bikaner, Rajasthan, India.

Introduction: The aim of this study was to evaluate the chemical composition of urinary stones and pattern of changes according to the patient's age in Northwestern Rajasthan using Fourier transform infrared (FTIR) spectroscopy.

Materials And Methods: A prospective study of 1005 urolithiasis patients was carried out in two tertiary care centers from September 2012 to September 2016. Chemical composition of urinary stones was analyzed using FTIR spectroscopy, and a subgroup study based on the patient's age was done (8-12 years - Group A, 13-18 years - Group B, and >18 years - Group C). Read More

Ren Fail 2018 Nov;40(1):357-362

b Department of Urology and Nephrology , Aksaray University , Aksaray , Turkey.

Staghorn stones are large branching stones that fill part of all of the renal pelvis and renal calyces and they can be complete or partial depending on the level of occupancy of the collecting system. Although kidney stones are commoner in men, staghorn stones are less often reported in men compared to women and they are usually unilateral. Due to the significant morbidity and potential mortality attributed to staghorn stones, prompt assessment and treatment is mandatory. Read More

Can Urol Assoc J 2018 Apr 22;12(4):131-136. Epub 2017 Dec 22.

The Stone Centre at Vancouver General Hospital, Department of Urologic Sciences, University of British Columbia, Vancouver BC, Canada.

Introduction: Struvite stones account for 15% of urinary calculi and are typically associated with urease-producing urinary tract infections and carry significant morbidity. This study aims to characterize struvite stones based on purity of stone composition, bacterial speciation, risk factors, and clinical features.

Methods: Retrospective data was collected from patients diagnosed with infection stones between 2008 and 2012. Read More

Int J Paleopathol 2017 12 1;19:18-23. Epub 2017 Sep 1.

University of Illinois Medical School, 1601 Parkview Avenue, Rockford, IL 61107, United States.

During the excavation of the 19th century Peoria City Cemetery (Peoria, Illinois), a skeleton of a female, aged 20-30 years old, was found with large, bilateral calcified masses in the abdominal region. The masses were analyzed by Fourier transform infrared (FTIR) spectroscopy, and the results compared to published clinical data in an effort to determine the etiology of the stones. The calcified masses were determined to be staghorn struvite uroliths, which commonly result from chronic urinary tract infection and likely impacted the overall health of this individual. Read More

J Endourol 2017 05 29;31(5):533-537. Epub 2017 Mar 29.

1 Department of Urology, Mount Sinai West, New York, New York.

Objective: To examine urine and stone bacteriology of struvite stone formers in a large cohort of patients undergoing percutaneous nephrolithotomy (PCNL).

Materials And Methods: A total of 1191 patients, with stone and urine cultures, treated with PCNL for renal calculi were included in the study. Statistical differences were assessed using Mann-Whitney U and T-tests. Read More

Rheumatology (Oxford) 2017 Mar;56(3):498-500

Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Cir Pediatr 2015 Apr 15;28(2):59-66. Epub 2015 Apr 15.

Servicio de Urología. Fundación Puigvert. Barcelona.

Introduction: Extracorporeal Shock Wave lithotripsy (ESWL) is the cornerstone of pediatric urolitiasis management. We evaluated its efficacy and complications in a series of children.

Material And Methods: Children who were managed with ESWL between 2003 and 2012 were retrospectively reviewed. Read More

Ceylon Med J 2016 Jun;61(2):74-6

Urology Unit, Colombo South Teaching Hospital, Sri Lanka.

The composition of renal stones varies widely among populations. The aim of our study was to determine the composition of staghorn renal stones using Fourier transform infrared (FTIR) spectroscopy in a cohort of Sri Lankan patients. Forty two staghorn calculi removed from kidneys of adult patients during open surgery were analysed. Read More

Dev Period Med 2016 Jan-Mar;20(1):23-6

Katedra i Klinika Pediatrii i Nefrologii, Warszawski Uniwersytet Medyczny, Polska.

Urolithiasis in children occurs with the incidence of 0.1-5%. Risk factors such as metabolic disorders, recurrent urinary tract infections and/or congenital abnormalities of urinary tract are detected in 75-85% of children with urolithiasis. Read More

J Endourol 2016 09 3;30(9):982-6. Epub 2016 Aug 3.

1 Department of Urology, Mayo Clinic , Rochester, Minnesota.

Introduction: We aim to describe pre- and postoperative predictors of infection-related complications in individuals undergoing percutaneous nephrolithotomy (PCNL).

Patients And Methods: Patients treated with PCNL from 2009 to 2013 were reviewed. Patients with positive urine or stone cultures received extended antimicrobial treatment. Read More

Urol Clin North Am 2015 Nov 26;42(4):459-72. Epub 2015 Jul 26.

Department of Urologic Surgery, Administrative Office, A-1302 Medical Center North, Vanderbilt University Medical Center, Nashville, TN 37232-2765, USA. Electronic address:

Infected kidney stones refer to stones that form because of urinary tract infections with urease-producing bacteria, secondarily infected stones of any composition, or stones obstructing the urinary tract leading to pyelonephritis. The mainstay of treatment of infection stones is complete stone removal. Kidney stones that obstruct the urinary tract and cause obstructive pyelonephritis are also frequently referred to as infected stones. Read More

J Endourol Case Rep 2015 1;1(1):21-3. Epub 2015 Oct 1.

Department of Urology, University of California , Irvine, Orange, California.

A 77-year-old female presented with bilateral staghorn calculi. She underwent an uneventful left percutaneous nephrolithotomy (PCNL); the stone analysis revealed a 90% struvite and 10% calcium phosphate stone. Treatment of the right stone was postponed by the patient. Read More

Arch Esp Urol 2014 Sep;67(7):650-3

Department of Urology. Clínica Universitaria de Navarra. Pamplona.Spain.

Objective: To describe two clinical cases of staghorn stones in renal allografts and to perform a review of this condition.

Methods/results: Case 1. 71-year-old woman with a renal transplant and recurrent UTI presented lithiasis in the graft on renal ultrasound. Read More

Urolithiasis 2014 Jun 19;42(3):283-4. Epub 2014 Mar 19.

Department of Urology, Korea University Guro Hospital, #148 Gurodong-ro, Guro-gu, Seoul, 152-703, Korea.

Saudi J Kidney Dis Transpl 2013 Mar;24(2):418-23

Department of Medicine, Babol University of Medical Sciences, Babol, Iran.

This study was conducted to determine the composition of staghorn stones and to assess the proportion of infected stones as well as the correlation between infection in the stones and bacteria grown in urine. Samples of 45 consecutive stones removed through anatrophic nephrolithotomic procedures were taken from the operation site and samples of urine were obtained by simultaneous bladder catheterization. The frequency of infection in the stones and correlation between infection of stone and urine samples were determined with respect to the composition of the stones. Read More

Urology 2013 May 20;81(5):943-8. Epub 2013 Mar 20.

Division of Nephrology, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH 43205, USA.

Objective: To characterize the clinical course after cutaneous vesicostomy (CV) in megabladder (mgb(-/-)) mice with functional urinary bladder obstruction.

Materials And Methods: A total of 45 mgb(-/-) male mice underwent CV at a median age of 25 days. The 34 mice that survived >3 days after CV were evaluated by serial observation and renal ultrasonography. Read More

Urology 2012 Nov 15;80(5):980-5. Epub 2012 Sep 15.

Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel.

Objective: To evaluate the importance of stone composition and crystallite size in the formation of ultimate stone burden. Crystallite is the smallest building block, which is unique in size and architecture for each type of stone component. Currently, the knowledge about the clinical importance of crystallite size is very limited. Read More

J Endourol 2012 Dec 24;26(12):1610-3. Epub 2012 Sep 24.

Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA.

Background And Purpose: Patients with spinal neuropathy are at an increased risk for urolithiasis. Data on percutaneous nephrolithotomy (PCNL) in this population are limited. Our objective is to review our experience in managing stones with PCNL in patients with spinal neuropathy. Read More

J Endourol 2012 Aug 17;26(8):954-9. Epub 2012 Apr 17.

The University of Western Ontario, St Joseph's Health Care, London, Ontario, Canada.

Renal stone disease is common among patients with spinal cord injury (SCI). They frequently have recurrent stones, staghorn calculi, and bilateral stone disease. The potential risk factors for stones in the SCI population are lesion level, bladder management strategy, specific metabolic changes, and frequent urinary tract infections. Read More

J Endourol 2012 Feb 14;26(2):110-8. Epub 2011 Oct 14.

Department of Urology, University of Florida, Gainesville, FL 32610, USA.

Background And Purpose: Over the last 50 years, chemolysis as a primary or adjuvant treatment for urinary stones has fallen in and out of favor. We review the literature for a historical perspective on the origins and chronology of Renacidin therapy, focusing on landmark studies and impracticalities that have seemingly condemned it to history.

Materials And Methods: A MEDLINE search was performed on the topic of chemolysis of urinary calculi. Read More

J Endourol 2011 Jun 20;25(6):947-54. Epub 2011 May 20.

Division of Urology, St. Michael's Hospital, Toronto, Ontario, Canada.

Background And Purpose: Percutaneous nephrolithotomy (PCNL) is considered standard therapy for large and complex renal calculi. The optimal patient position and puncture site for collecting system access remains controversial. This purpose of this retrospective review is to analyze our PCNL series with respect to puncture tracts, success, and complications using our novel prone-flexed position. Read More

Arch Ital Urol Androl 2010 Mar;82(1):37-40

The Comprehensive Kidney Stone Center, Department of Urology, Duke University Medical Center Durham, North Carolina 27710, USA.

Introduction: Percutaneous nephrolithotomy (PNL) remains the treatment of choice for managing patients with large or complex renal calculi, especially staghorn stones composed of struvite. Recent advances in the PNL technique appear to improve post-operative outcomes and reduce patient morbidity.

Materials And Methods: A thorough review of the recent urologic literature was performed to identify results and, benefits of percutaneous nephrolithotomy versus either combination PNL and shock wave lithotripsy or SWL alone. Read More

Int Urol Nephrol 2011 Mar 8;43(1):61-5. Epub 2010 Jun 8.

Department of Urology, University Hospital of Heraklion, University of Crete Medical School, 71110, Heraklion, Crete, Greece.

Aim: The presentation of our results using the Dornier lithotripter (Doli) S electromagnetic shockwave emitter (EMSE) 220 F-XP for the strategic management of staghorn renal calculi.

Methods: Sixteen patients with renal staghorn stones of more than 35 mm in maximum length on plain X-rays were treated by shock wave lithotripsy (SWL) monotherapy with the Doli S EMSE 220 F-XP. Double-J ureteral stent was inserted to all prior to the first SWL treatment. Read More

J Coll Physicians Surg Pak 2009 Jan;19(1):69-70

Department of Radiology, Combined Military Hospital, Bahawalpur.

Crossed fused renal ectopia is a rare renal anomaly. Formation of staghorn and struvite calculi within it has never been reported in local literature. A 25-year-old man with macrohematuria and right flank pain was admitted to the hospital. Read More

Urol Res 2008 Oct 16;36(5):265-73. Epub 2008 Sep 16.

Crystal Growth Laboratory, Department of Physics, Saurashtra University, Rajkot, 360 005, Gujarat, India.

Struvite, one of the components of urinary stone grows rapidly forming "staghorn-calculi", is a painful urological disorder. It is necessary to study the growth-inhibition of Struvite crystals. This in vitro study has been carried out in the presence of the juice of Citrus medica Linn. Read More

J Mater Sci Mater Med 2009 Dec 21;20 Suppl 1:S85-92. Epub 2008 Jun 21.

Crystal Growth Laboratory, Department of Physics, Saurashtra University, Rajkot 360 005, Gujarat, India.

Struvite is one of the components of urinary stone. Large number of people is suffering from urinary stones (calculi) problem all over the globe. These stones can grow rapidly forming "staghorn-calculi", which is more painful urological disorder. Read More

Urol Clin North Am 2007 Aug;34(3):363-74

Department of Urology, The Emory Clinic, Emory University School of Medicine, 1365 Clifton Rd., Suite B, Atlanta, GA 30322, USA.

The American Urological Association Nephrolithiasis Guidelines Panel recently conducted a critical meta-analysis of the existing literature to determine the optimal management for staghorn calculi. This article briefly discusses the pathophysiology of staghorn calculi and, based on the panel's recommendations, examines the alternative medical treatments (eg, chemolysis) and surgical treatments (eg, shock wave lithotripsy, open surgery, ureteroscopy, and percutaneous nephrolithotomy) available for staghorn patients. Considering the various modalities for staghorn disease, percutaneous nephrolithotomy should be the first-line treatment for most patients based on its superior efficacy and low morbidity. Read More

Clin Nephrol 2007 Jun;67(6):404-5

J Endourol 2005 Oct;19(8):968-72

Department of Urology, All India Institute of Medical Sciences, New Delhi, India.

Background And Purpose: To evaluate the safety and efficacy of percutaneous nephrolithotomy (PCNL) for the management of complete staghorn calculi in children
Patients And Methods: The charts of 19 preschool children (15 boys, 4 girls) aged 20 months to 5 years (mean 4.2 years) with complete staghorn calculi who underwent PCNL at our center over a 3-year period were reviewed. Read More

Ann Urol (Paris) 2005 Feb;39(1):16-29

Service de néphrologie, centre hospitalier et universitaire, hôpital de la Maison-Blanche, 45, rue Cognacq-Jay, 51092 Reims cedex, France.

"Infection Lithiasis" refers to calculi that occur with persistent urinary tract infection. Stones composed of magnesium ammonium phosphate (struvite) and carbonate apatite, called "triple phosphate" stones, are the more common type of infection lithiasis. These stones are also called "staghorn" calculi because they may grow rapidly and fill the entire collecting system. Read More

Int J Urol 2005 Jan;12(1):12-6

Department of Urology, All India Institute of Medical Science, New Delhi, India.

Background: The purpose of the present paper was to study the spectrum of stone composition of upper urinary tract calculi by X-ray diffraction crystallography technique, in patients managed at All India Institute of Medical Sciences.

Methods: Between 30 April 1998 and 31 March 2003, a total of 1050 urinary calculi (900 renal, 150 ureteric) were analyzed. The stone fragments were collected after extracorporeal shock-wave lithotripsy, or retrieval by endoscopic (percutaneous nephrolithotomy, ureterorenoscopy), laparoscopic and various open surgical procedures. Read More

J Chin Med Assoc 2004 May;67(5):235-8

Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Background: Crystallographic composition of urinary tract stone varies in several chemical groups and determines the degree of fragmentation to extracorporeal shock wave lithotripsy (ESWL) which has been widely used for the treatment of renal and ureteral calculi. Visual prediction of stone composition by its morphology from plain radiograph may provide a simple method and clinical hint to decide therapeutic modalities. A prospective study was designed to determine the correlation of stone composition with its radiographic morphology. Read More

Int J Urol 2004 May;11(5):276-81

Department of Urology, Sanjukai Hospital, Sapporo, Hokkaido, Japan.

Purpose: To elucidate the factors contributing to staghorn stone formation in patients.

Materials And Methods: The records of 82 patients (44 men and 38 women) with complete staghorn calculi were reviewed retrospectively for clinical presentation, metabolic disturbances and anatomical abnormalities.

Results: There were 79 unilateral and three bilateral cases. Read More

J Urol 2003 Oct;170(4 Pt 1):1105-10

Department of Urology, San Carlo Borromeo Hospital, Milano, Italy.

Purpose: We describe a more efficient solution for calcium magnesium stones, an irrigation technique devised by us, and the indications for and results of our 20-year experience with direct renal or ureteral chemolysis.

Materials And Methods: Renal and ureteral perfusion is performed with 2 coaxial catheters (where the interspace is 1-way circulation), a normal ureteral catheter to a nephrostomy tube or, if the ureter is impractical, a nephrostomy tube after inserting it in a thin catheter achieving coaxial circulation. The perfusion operates by gravity with continuous flow maintaining a negative pressure in the cavities and keeping the circuits sealed during treatment. Read More

Urology 2003 Jul;62(1):197; author reply 197-8

J Urol 2003 Jul;170(1):48-51

Department of Urology, Duke University Medical Center, Durham, NC 27710, USA.

Purpose: Percutaneous treatment of patients with calculi in a horseshoe kidney can be challenging due to the altered anatomical relationship in the retroperitoneum. Therefore, we performed a multi-institutional review to assess the safety and efficacy of this minimally invasive technique.

Materials And Methods: Of 37 patients identified with calculi in a horseshoe kidney at 3 institutions 24 (65%) underwent percutaneous nephrolithotripsy as primary treatment. Read More

Ther Umsch 2003 Feb;60(2):89-97

Urologische Universitätsklinik, Inselspital, Bern.

While calcium oxalate and calcium phosphate make up at least 80% of all kidney stones, infection-induced and uric acid stones occur in 10% and 8%, respectively. Although any type of stone may become infected, the term "infection stones" means that stone formation exclusively depends on urease-producing bacteria. The splitting of urea leads to a rise in urinary pH which may induce crystallization of struvite (magnesium-ammonium-phosphate), the major constituent of infection stones, or carbonate apatite. Read More

Endocrinol Metab Clin North Am 2002 Dec;31(4):951-77

Department of Urology, SUNY, Upstate Medical University, Syracuse, NY 13210, USA.

Urinary stone disease is the only clinical presentation in patients with cystinuria. Two genes have been associated with type I (SLC3A1) and non-type I (SLC7A9) cystinuria and multiple mutations of these genes have been identified. The type I form is completely recessive while the non-type I form is incompletely recessive. Read More

Int Urol Nephrol 2001 ;33(2):293-8

Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.

Aim: To prospectively evaluate the efficacy and outcome of surgical intervention in patients with renal stones and chronic renal insufficiency.

Methods: The study was carried out from January 1999 till January 2001. Only patients with chronic renal failure without medical renal disease were taken up for study. Read More

Urology 2002 Apr;59(4):601

Department of Urology, Children's Hospital and Health Center, San Diego, California, USA.

Staghorn calculi are infrequent and generally are infected stones. Struvite or apatite calculi are embedded with gram-negative bacteria, which can produce endotoxin. Sepsis syndrome may occur after surgical therapy or endoscopic manipulation of infected or staghorn calculi. Read More

Eur Urol 2001 May;39(5):586-90

Bristol Urological Institute, Southmead Hospital, Bristol, UK.

Objective: Citric acid, in varying concentrations, has been used in the dissolution treatment of struvite renal calculi. Solution R (Uro-trainer), which contains 6% citric acid, is a solution licensed for use in the management of struvite stone disease in the UK. We report our experience. Read More

Urol Int 1999 ;63(4):228-33

Department of Urology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Objective: To assess the role of primary open surgery versus the recommended combination approach (percutaneous and lithotripsy) to treat staghorn calculi in a developing country.

Patients And Methods: Available records (n = 91) of patients with staghorn managed during the last 4 years were retrieved. Patients were placed in two groups, open surgery and combination group, according to the primary procedure chosen by the patient. Read More

Tech Urol 1999 Sep;5(3):155-8

Department of Surgery, University of Chicago Pritzker School of Medicine, Illinois 60637, USA.

The treatment of patients with staghorn calculi remains a challenging problem. Combination therapy using percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy has been recommended as the best option for most patients. Using this technique, 10 (83%) of 12 renal units with partial or complete staghorn calculi were rendered stone-free, with no significant septic episodes or serious complications. Read More

Urology 1998 Nov;52(5):882-4

James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.

We report a case of bilateral struvite and matrix staghorn calculi in a quadriplegic man with severe upper and lower extremity contractures that prevented percutaneous nephrolithotomy. Bilateral ureteroscopic lithotripsy was performed but the "snowstorm" of particles and viscous matrix material prevented complete stone clearance with the ureteroscope alone. Irrigation and aspiration through a fluoroscopically positioned nasogastric tube allowed evacuation of stone debris, mucinous matrix, and completion of the procedure. Read More

Urol Clin North Am 1997 Feb;24(1):71-80

Department of Urology, Mayo Clinic, Rochester, Minnesota, USA.

Struvite staghorn calculi are infected stones that represent a real threat to the kidney and to the patient and are an indication for active treatment in most individuals. SWL, PL, combined PL and SWI, and open surgery are all viable treatment options for these patients. Most patients should be treated with combined therapy, reserving SWL for small-volume stones and open surgery for difficult situations that do not lend themselves to combined treatment. Read More

J Endourol 1995 Oct;9(5):375-7

Department of Urology, Ruhr-University Bochum, Germany.

Minimal invasiveness characterizes modern stone therapy. Several years ago, we presented the Swiss Lithoclast, a ballistic system for endoscopic stone therapy. Its disintegrational power is superior to that of the other intracorporeal lithotripsy devices, and it has gained great recognition. Read More