RG LUDHIANA: Management Of Massive Right Staghorn Kidney Stone (9 × 5 cm) With Severe Hydronephrosis

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FACULTY:
Dr. Vaibhav Sood - Consultant Urology
Dr. Amit- Consultant Anesthesia

PRESENTING / CHIEF COMPLAINTS:
The patient presented with pain in the right flank region.
NCCT KUB showed a Right staghorn kidney stone causing obstruction and severe hydronephrosis. The patient was admitted for further treatment and surgical management.

CLINICAL FINDINGS:

  • Right staghorn renal stone.
  • Obstruction in the right kidney.
  • Severe hydronephrosis (swelling of the kidney).
  • Stone filling the renal pelvis and multiple calyces.
  • Few small non-obstructive stones in the right kidney.
  • Left renal calcification noted.
  • DIAGNOSIS:

Right obstructive staghorn calculus measuring approximately 9 × 5 cm with severe hydronephrosis.

TREATMENT PERFORMED:
Right PCNL (Percutaneous Nephrolithotomy) with DJ Stent placement under General Anesthesia.

SPECIAL NOTE:
This case highlights, Dr. Vaibhav Sood's expertise in  successfully removing a massive staghorn kidney stone measuring approximately 9 × 5 cm using advanced minimally invasive techniques, while preserving the kidney function.
The surgery involved a dual-tract Percutaneous Nephrolithotomy (PCNL), where two access channels were created to different parts of the kidney. This allowed the surgical team to remove the entire stone in a single sitting. The stone fragmentation phase lasted about 90 minutes, and complete stone clearance was achieved.

After surgery, the patient recovered well, with serum creatinine improving from 1.5 mg/dL to 1.3 mg/dL, indicating better kidney function.

HIGHLIGHTS OF THE CASE:

  • Large staghorn kidney stone.
  • Severe hydronephrosis.
  • Advanced PCNL surgery performed.
  • Laser stone fragmentation.
  • Successful removal of complex kidney stone.
  • Stable recovery after treatment.

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