Branched renal calculi treated by percutaneous nephrolithotomy and extracorporeal shock waves.
Fifty-four renal staghorn calculi, 26 complete and 28 partial, were treated in 51 patients by percutaneous nephrolithotomy (PCN) in combination with extracorporeal shock wave lithotripsy (ESWL) when necessary. At an average time of observation of 11.1 months, 56% of the renal units were stone free. Twenty-two per cent had residual gravel of less than 2 mm in diameter and 15% contained residuals between 2 and 5 mm in diameter. Seven per cent of the kidneys had significant residual calculi. Additional endourological procedures were required in 13 cases. Complications were minimal and were all conservatively treated. PCN in combination with ESWL is an effective treatment of most branched renal calculi. The methods may be used repeatedly without increasing technical difficulty. The results compare well with open surgery.