Patient: A 71-year-old male with a history of diabetes mellitus and previous left open nephrolithotomy (20 years ago). Laboratory evaluation showed Hb 15.6 g/dL, WBC 5700/μL, and serum creatinine 1.2 mg/dL.
Imaging Findings:
Non-contrast CT scan of the left kidney demonstrated a complete staghorn calculus occupying the entire renal pelvis and extending into all calyces.
Procedure:
Percutaneous nephrolithotomy (PCNL) was performed on the left kidney via an upper-pole intercostal approach between the 11th and 12th ribs. Intraoperative irrigation remained completely clear throughout the procedure, and complete stone fragmentation and extraction were achieved.
Outcome:
The patient was rendered stone-free postoperatively without complications.
Amir H Kashi
Associate Professor of urology
Ali Adib
Fellowship of endourology