Urology · NEET PG Preparation Surgery
A 55-year-old female presents with recurrent urinary tract infections and left flank pain. Non-contrast CT scan of the abdomen shows a large staghorn…
Practice question from Urology (NEET PG Preparation Surgery), with the correct answer and a step-by-step solution.
medium · MCQ · Q-820F25
A 55-year-old female presents with recurrent urinary tract infections and left flank pain. Non-contrast CT scan of the abdomen shows a large staghorn calculus occupying the renal pelvis and multiple calyces of the left kidney, measuring approximately 4.5 cm in diameter. Urine culture grows Proteus mirabilis. Which of the following is the most effective definitive treatment for this stone burden?
- A.Extracorporeal shock wave lithotripsy (ESWL) monotherapy
- B.Percutaneous nephrolithotomy (PCNL)Correct answer
- C.Oral chemoprophylaxis with potassium citrate alone
- D.Diagnostic ureteroscopy with laser lithotripsy
Solution
Staghorn calculi are large branched stones that fill the renal pelvis and calyces, typically composed of struvite (magnesium ammonium phosphate) associated with urease-producing bacterial infections (Proteus, Pseudomonas, Klebsiella). The gold standard treatment for a complex staghorn stone greater than 2 cm is percutaneous nephrolithotomy (PCNL) to achieve maximum stone-free rates.
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