Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy

Jaime Landman, Ramakrishna Venkatesh, David I. Lee, Jamil Rehman, Maged Ragab, Michael Darcy, Chandru P. Sundaram

Research output: Contribution to journalArticle

44 Scopus citations


Purpose: We describe our technique and clinical experience with application of the ureteral access sheath for single access ablation of staghorn and partial staghorn calculi. Materials and Methods: We retrospectively reviewed our experience with 9 patients who underwent percutaneous nephrolithotomy for staghorn (6) or partial staghorn (3) renal calculi using a combined antegrade and retrograde approach. Patient data, operative parameters, efficacy of stone ablation and convalescence parameters were reviewed. Results: Mean operative time for the primary procedure was 3.1 hours with a mean estimated blood loss of 290 ml. Postoperatively, the mean analgesic requirement was 33.2 mg. MSO4 equivalents. Hospital stay was 3.2 days. There were no major and 4 minor (44%) complications. No patient required transfusion. Complete stone clearance was achieved in 7 of the 9 cases (78%) using a single percutaneous nephrostomy tract. Conclusions: Our preliminary clinical experience using the ureteral access sheath during percutaneous nephrolithotomy for simultaneous antegrade and retrograde stone treatment has been favorable. A large renal stone burden can be successfully managed with a single percutaneous access and limited blood loss.

Original languageEnglish (US)
Pages (from-to)64-67
Number of pages4
JournalJournal of Urology
Issue number1
StatePublished - Jan 1 2003



  • Kidney
  • Kidney calculi
  • Nephrostomy, percutaneous
  • Surgical instruments
  • Ureter

ASJC Scopus subject areas

  • Urology

Cite this