Q: I am a 50 years old man having stones in both the kidneys. My left kidney was operated and stones were removed through extracorporeal shock wave lithotripsy (ESWL) procedure. Four months ago I had a heart attack and the angiogram report stated that I had recanalised right carotid artery (RCA) with no blocks; so I took medicines for the same for 3 months. Then the cardiologist certified me to go for right kidney surgery after Dobutamine stress echo was negative. My right kidney has two large stag horn calculi measuring approximately 20 mm and 30 mm. What type of surgery is less risky for my kidney? The doctor suggested percutaneous nephrolithotomy (PCNL) and on second opinion another doctor suggested open surgery. My creatinine is 1.6 mg/dl. What should I do? Please advise.

A:These days open surgery is rarely done for most patients with stone disease because of advantages of less invasion,less pain, quicker recovery and shorter hospitalization.However the centre doing your surgery has to have urologists with adequqte experience in endourology procedure.Most modern urology centres have qualified and experienced personnel and doctors.