RENAL STONE SURGERY USING COAGULUM REDUCES RESIDUAL STONES AND TRUE RECURRENCE

We studied whether coagulum renal stone surgery reduces residual stones and true recurrence. Diagnosis of the recurrence was given only to those confirmed by KUB and IVP. As to single stone, no residual stone was found in any of 56 cases of pyelolithotomy, 10 cases of coagulum pyelolithotomy and 2 cases of nephrolithotomy. In the cases of multiple stones, residual stones were found in 11 of 26 cases of pyelolithotomy (42%), 9 of 34 cases of coagulum pyelolithotomy (27%). Stones were retained in 3 of 10 cases (30%) of nephrolithotomy and 5 of 16 cases (31%) of coagulum nephrolithotomy performed to remove staghorn stones. Recurrences were observed in 9 out of 44 cases (20%) which underwent pyelolithotomy (average observation period-20 months) and 3 out of 28 cases (12%) of coagulum pyelolithotomy (average observation period-23 months). True recurrences were noted in 2 out of 9 cases (22%) of nephrolithotomy (average observation period-13 months) and in 2 out of 10 cases of coagulum nephrolithotomy (20%, average observation period-23 months). As to urinary infection or stone composition, there was no difference between the cases in which coagulum was used and those in which it was not used. Considering that coagulum was employed both in pyelolithotomy and nephrolithotomy for the cases of complex stones, it is concluded that residual stones and true recurrence were reduced by the use of coagulum.