STAGHORN CALCULUS
It is the stone occupying the renal pelvis and calyces. It is usually phosphate or ammonium, magnesium phosphate (Triple phosphate) stone.
It is white in colour, soft, smooth, occurs in pre-existing infection (commonly E. coli).It can be unilateral or bilateral.
Patient with bilateral stones may go in for renal failure.
RECURRENCE OF STONES
Types of recurrence:
- False recurrence—during intervention, tiny fragments may be left behind.
- True recurrence—recurred again once all stones are cleared byintervention.
CAUSES FOR RECURRENCE:
Existing causes like hyperparathyroidism, hypercalciuria, hyperuricaemia, gout, cystinuria.
PREVENTION :
- Hydration is the main method of prevention. Per day 3 to 4 litres of fluid should be taken.
- Diet: Avoid diets rich in calcium oxalate, sodium (natriuresis causes
- hypercalciuria) and vitamin C (gets converted into oxalate).
- Increased intake of dietary fibre—binds with intestinal calcium and decreases the calcium absorption. Sodium cellulose phosphate is used for the same.
- Diet rich in magnesium makes calcium oxalate less soluble.
INVESTIGATIONS
- Ultrasound abdomen.
- X-ray- KUB.
- IVU
- Blood urea and serum creatinine.
- Urine microscopy
- urine C/S.
- Isotope renogram—DTPA
COMPLICATIONS OF STAGHORN CALCULUS
- Pyelonephritis
- Pyonephrosis
- Perinephric abscess
- Renal failure
HOMOEOPATHIC MANAGEMENT:
- Argentum nit:
- Belladonna:
- Benzoic acid:
- Berberis Vulgaris:
- Lycopodium clavatum:
- Hydrangea arborescens
