Q: I am a 32 years old man who had multiple stones in the right kidney. I had an intravenous pyelogram (IVP) done two days ago, which showed relative delayed excretion of the dye with hydrocalyx. The renal pelvis seen occupied by part of the mentioned renal calculus with no dilatation. The visualised right ureter seen was unremarkable. The left kidney showed normal excretion of the dye with normal pelvicalyceal system and cystogram. The post void films showed holding up of the dye in the right kidney. Conclusion: Right renal staghorn calculus back pressure change. KUB (kidney, ureter and bladder) showed: Staghorn calculus seen at the right kidney, measuring 37 x 23 mm surrounded laterally by multiple renal calculi seen. The doctors advised to do PCNL / open surgery. Which procedure I should follow?

A:Surgical method for removal of kidney stone depends upon the size and the location of the stone. In view of large sized complex stone, it would be preferable to undergo percutaneous nephrolithotomy (PCNL) or the open surgery as decided by your Urologist after reviewing the imaging studies as described. The other method called Extracorporeal Shock Wave Lithotripsy (ESWL) is usually preferred for stones measuring under 2 cms.