1981 Volume 72 Issue 2 Pages 185-191
Pyelolithotomy was performed in 42 cases, coagulum pyelolithotomy in 22 cases, nephrolithotomy in 8 cases, and nephrolithotomy using coagulum (coagulum nephrolithotomy) in 10 cases. The rate of residual stone was zero when the stone was single. In the case of multiple stones or staghorn calculi, the rate of the failure to remove all the stones were 45% in pyelolithotomy (20 cases), 21% in coagulum pyelolithotomy (14 cases), 67% in nephrolithotomy (3 cases), and 20% in coagulum nephrolithotomy (10 cases). Thus, the use of coagulum increased the rate of success to remove all the stones.
Frequently sand-like stones or small stones that cannot be recognized by X-ray were removed with coagulum.
Although there is no indication for coagulum pyelolithotomy when the extrarenal pelvis is small or the infundibulum of the calyx is narrow, the coagulum nephrolithotomy can be done effectively in such situations. Furthermore, it is easier to remove the coagulum intact in coagulum nephrolithotomy than in coagulum pyelolithotomy. Therefore, the advantage of using coagulum is greater in nephrolithotomy than in pyelolithotomy.
