It is the stone occupying the renal pelvis and calyces. It is usually phosphate or ammonium, magnesium phosphate (Triple phosphate) stone.
It is white in colour, soft, smooth, occurs in pre-existing infection (commonly E. coli).It can be unilateral or bilateral.
Patient with bilateral stones may go in for renal failure.
RECURRENCE OF STONES
Types of recurrence:
- False recurrence—during intervention, tiny fragments may be left behind.
- True recurrence—recurred again once all stones are cleared byintervention.
CAUSES FOR RECURRENCE:
Existing causes like hyperparathyroidism, hypercalciuria, hyperuricaemia, gout, cystinuria.
- Hydration is the main method of prevention. Per day 3 to 4 litres of fluid should be taken.
- Diet: Avoid diets rich in calcium oxalate, sodium (natriuresis causes
- hypercalciuria) and vitamin C (gets converted into oxalate).
- Increased intake of dietary fibre—binds with intestinal calcium and decreases the calcium absorption. Sodium cellulose phosphate is used for the same.
- Diet rich in magnesium makes calcium oxalate less soluble.
- Ultrasound abdomen.
- X-ray- KUB.
- Blood urea and serum creatinine.
- Urine microscopy
- urine C/S.
- Isotope renogram—DTPA
COMPLICATIONS OF STAGHORN CALCULUS
- Perinephric abscess
- Renal failure
- Argentum nit:
- Benzoic acid:
- Berberis Vulgaris:
- Lycopodium clavatum:
- Hydrangea arborescens