What is a staghorn calculus? 

A rare type of kidney stone is staghorn calculus. Particularly in this case calculus means a stone and its plural is called calculi or stone. Staghorn calculus is another name for branching kidney stones. In many cases it is formed if any person gets repeated urinary tract infections (UTIs). In case if Urinary tract infections (UTIs) is a reason behind their formation then most probably it is possible that they are made from struvite, a compound of ammonium, phosphate and magnesium. Other than that if they are the result of a small stone grown bigger over the time, the staghorn calculi are the mixture of calcium oxalate, calcium pyrophosphate or  a compound of calcium carbonate apatite also with struvite. 

This type of kidney stone is named as staghorn for referring to its shape. This type of kidney stone appears like a price of coral or as the horns of deer. These stone branches grow in that  way which can block the calyces and the pelvis of the person’s kidney. Thus can result in renal failure. The calyces and the pelvis are the part of your kidney which are responsible for the which works as a drainage system and helps in the excretion of fluid waste known as urine from a person’s kidneys. Generally, staghorn calculus is found in only one kidney, however it can be formed in both the kidneys together. 

Who will be at the higher risk of getting staghorn calculus?

If any of these symptoms are visible in any person then he or she will be at higher risk of staghorn calculus development: 

• If the person have spinal injury 
• If the person is suffering from Urinary tract infection.
• If the person has a neurogenic bladder. 

How does staghorn calculus affect the patient’s body? 

Staghorn calculus affects the patient’s body by blocking their body partially or completely. In this condition the branches of staghorn stone develop into the patient’s renal pelvis which is a funnel shaped structure responsible for collecting urine and sending it to the two thin tubes of muscles known as ureters. After the completion of the filtration the waste fluid travels to the bladder from the ureter in the form of urine and gets stored there. If the patient’s ureter or pelvis gets blocked because of any reason then this can result in swelling of the kidney. 

It is possible that the patient’s calyces can be blocked by staghorn calculus. If the patient’s calyces swell because of any reason such as excess fluid then it can be later developed into caliectasis, if this condition is left untreated then it can further result in kidney failure. 

What are the symptoms of a staghorn calculus? 

Here we have listed below some of the symptoms of a staghorn calculus patient: 

• Frequent occurrence of fever.
• Feeling pain at the side of the ribs and hips. 
• Feeling always tired. 
• Getting blood in urine. 
• Occurrence of pus in urine. 

What are the causes of staghorn calculus? 

One of the most common causes of staghorn calculus is repeated urinary tract infections, particularly when bacteria which are responsible for causing infections starts producing a special type of enzyme known as urease. Proteus mirabilis is one of these bacteria. It reduces the pH levels of the patient’s urine and makes it less acidic because of which the crystals get formed and result in kidney failure. Other causes of staghorn calculus includes: 

• Any type of blockage in the urinary tract. 
• Untreated kidney stone from long term. 
• Excess use of urinary catheter. 
• Having a neurogenic bladder by birth.
• Any type of specific which is responsible for the stone formation. 
• Continuing or had an urinary diversion procedure earlier. 

How is staghorn calculus diagnosed? 

For the diagnosis of staghorn calculus most probably the healthcare provider of the patients will order them an X-ray report of their kidneys. Most of the health providers usually order for an X-ray because staghorn calculus is radiopaque and it can be clearly seen in the  X-ray reports. Radiopaque is the term used for the objects which can be shown on X-ray. 

Additionally, it is possible that the healthcare providers will also order the patients a computed tomography (CT) scan for the analysis of staghorn calculus accurately. 

What is the treatment for staghorn calculus? 

Usually staghorn calculus is treated  with the help of surgical procedure. In the surgical procedure of treating staghorn calculus the whole stone or its small pieces are removed so that they cannot cause any type of  infection and become unable to form into new stone. 

One of the most appropriate ways for the removal of staghorn calculus is with the help of a percutaneous nephrolithotomy (PCNL).  Some other ways of removing staghorn calculus include two types of lithotripsy, thulium fiber laser lithotripsy and holmium. 

Percutaneous nephrolithotomy for the treatment of staghorn calculus 

For removing the stones which are too big to get past their own PCNL treatment is used. In order to perform this PCNL treatment the surgery makes a cut at the back of the patients for reaching to the   kidney then a small tube is put in that cut so that the instruments can get inside the kidney for breaking and removing the stone. A special type of surgical instrument which is called a nephroscope is used in this surgery. A Nephroscope is particularly a camera which helps finding stone and removing it from the kidney. 

This surgery will be performed on patients by giving them doses of general anesthesia. It is mandatory for the patient to remain in the hospital for one to two days after the completion of this surgery. In some of the special cases surgeons leave the small tube used in the surgery in the patient’s back for some days during the healing period of the kidney. However, in common cases they place a small internal tube known as ureteral stent. 

Ureteral stent 

It might be possible that you have heard someone talk about tubule surgery. This is a type of PCNL treatment in which it is not necessary for the patients to have a drainage pipe in their back but in this treatment patients will still have an internal tube known as a stent placed inside their body.  Ureteral stent is particularly a nonpermanent small tube made up from plastic which is placed inside the patients ureter it specifically helps for the draining of the urine from the patient’s kidneys to their bladder. The reason behind placing ureteral stents in your kidney is to unblock the patient’s kidney if any obstruction or stone is present there but it also helps the ureter for staying open after the survey. 

Ureteroscopy for the treatment of staghorn calculus 

A ureteroscopy is a special type of treatment which is performed by most of the healthcare providers through the tunes or ureters which are responsible for connecting the kidneys to the bladder. In this procedure tiny instruments are used. Some tiny surgical equipment is also involved with this procedure. Ureteroscopy is also known as an ureterorenoscopy. It is most probably possible that you have heard about terms such as URS or U-scope. 

Retrograde internal surgery is another name for flexible ureteroscopy. In this flexible ureteroscopy a patient’s healthcare provider can perform the procedure without making any cut and by putting the instruments from the patient’s urethra to the patient’s kidney. 

Combination therapy for the treatment of staghorn calculus

In each and every therapy for the treatment of staghorn calculus one complication is common that they are hundred percent effective every time. Most of the time  small pieces of stones are left over in the patient’s kidneys. Many treatments include loss of some blood from the patient’s body. Patients will be provided antibiotics and pain relievers after the surgery by their healthcare providers. Risk of infection is also there if urine is not sterile or clean. 

How to reduce the risk of staghorn calculus development again after the surgery? 

We have listed some ways below which can help the patients to reduce the risk of staghorn calculus development again after the surgery: 

• Patients will have to follow specific and recommended diets. 
• Patients will have to take antibiotics to reduce the risks of any type of infection. 
• Patients will have to take acetohydroxamic acid which is an urease inhibitor. 

What are the complications of having staghorn calculus? 

If the person is getting proper treatment of staghorn calculus then they may get another stone, or may not get another stone. However, he or she will get relieved from their pain and he or she will be able to pee normally after the treatment. 

In any case if person left the staghorn calculus untreated for a long time then it may result to sever condition such as: 

• Excess fluid builds up in the body which can further lead to caliectasis, swelling in the calyces of the kidney.
• Different types of kidney infections. 

• Kidney failure, a situation in which the kidney gets completely unable to perform the filtration work of toxins and excessive fluids from the body. 
• A critical infection of the urinary tract known as urosepsis, it can be fatal. 

Still, those people who are not eligible for the surgical procedure can opt for non surgical treatment known as Conservative management. A person can live a normal life with staghorn calculus if he or she will visit a doctor regularly and follow their suggestions. 

How much time  is required for getting recovered after the treatment of staghorn calculus? 

The time of getting recovered after the treatment of staghorn calculus completely depends upon the type of treatment given to the patient of staghorn calculus. The more time will be taken by the patients to recover if they have had open surgery. There are some types of surgery which will allow the patients to get their home back the same day because they include minimally invasive techniques. The patient will be informed by their doctors about when they should get back to their normal urine and allowed for lifting weights. 

When should patients contact their healthcare providers? 

It is necessary for the patients to contact their healthcare providers when they observe the symptoms mentioned below: 

• Getting fever over then 100 degree fahrenheit. 
• Not getting any improvement in their health condition. 
• Getting unable to urinate. 
• Experiencing excessive bleeding. 
•  If they are continuously trembling because of high fever. 

Overview 

Just like any other type of kidney stone, staghorn calculus is also frustrating and painful. Patients will be analyzed by their healthcare provider and get proper treatment from them for curing their problem. Surgery is suggested by most doctors as the solution of staghorn calculus. Treatment of staghorn calculus is important to avoid kidney failure. It will be very much beneficial for the patients to follow the recommendations from their doctors about their diet and activity level.