It was concluded that PCNL, performed after an imaging study and careful assessment of the renal anatomy and related structures, can be a safe and effective monotherapy for patients with staghorn calculi in horseshoes kidney. Only one patient suffered a long-term urinary tract infection of three months’ duration, and temporary deterioration in renal function. 4 Complete stone clearance was achieved in all the patients. treated 8 patients with staghorn calculi in a horseshoe kidney by percutaneous nephrolithotomy (PCNL). Percutaneous extraction of stones from horseshoe kidneys has been done safely and is considered the standard of care. The reported cases in the literature of a staghorn calculi in a horseshoe kidneys were 19, 2 3,3 8,4 and 35 cases. The association of horseshoe kidneys with staghorn calculus formation is rare. The horseshoe kidney, even though it produces no symptoms, is frequently found in association with other congenital anomalies including genital anomalies: hypospadias - 4%, undescended testes - 4%, bicornuate uterus - 7% and septate vagina - 7% urinary collecting system anomalies: ureteral duplication - 10%, ureteropelvic junction obstruction - 20%, vesicoureteral reflux -50% renal parenchymal abnormalities: multicystic dysplasia - 1%, autosomal recessive polycystic kidney - 1%, and metabolic derangements in patients with stones in 50%: hypercalciuria, hyperoxaluria, hypocitraturia, hypouricuria. It occurs in 0.25% of the population (1 in 400 persons). The horseshoe kidney is the most common of all renal fusion anomalies. The staghorn calculus extracted from the horseshoe kidney.
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