Conservative Management of Staghorn Calculi: When Is It Safe?

Journal of Endourology
Tara Nikonow MorganMichelle Jo Semins

Abstract

To describe the clinical characteristics, infectious and kidney function patterns, and overall outcomes in a cohort of patients with staghorn calculi treated conservatively. Staghorn calculi treated nonoperatively between January 2009 and January 2017 were identified. A retrospective analysis was completed. Twenty-nine patients were identified with a median age of 74 years (interquartile range [IQR] 61-81). Mean follow-up was 24 months. Fifty-nine percent (17/29) had complete staghorn calculi with 6/29 (21%) bilateral. Mean body mass index was 29.4 (IQR 24.8-31.7). Of the 29 patients, 14 were treated conservatively due to comorbidities, 12 refused treatments, and 3 were due to aberrant anatomy. The age-adjusted Charlson Comorbidity Index (CCI) score demonstrated 8 patients in our cohort with a CCI of <3, 11 patients with a CCI of 4 or 5, 7 patients with a CCI of 6 or 7, and 3 patients with a CCI of >8. Overall, kidney function remained stable for 19/29 patients (66%) and the glomerular filtration rate decreased by <10% for 4/29 (14%), by 10%-29% for 2/29 (7%), and >30% for 4/29 patients (14%) over the study period. None of the study patients required hemodialysis. No patients in the cohort developed an abscess, nor were any pat...Continue Reading

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Citations

Jan 11, 2020·Annals of the Royal College of Surgeons of England·M AlsawiO Aboumarzouk
Nov 8, 2020·Nature Reviews. Urology·Ashley AlfordJody Lulich
Feb 22, 2021·Indian Journal of Medical Microbiology·S Shah UtsavS Tamhankar Ashwin

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