Staghorn Kidney Stone: Causes, Symptoms, And Treatment Options 2023

Kidney stones can be incredibly agonizing, and if you have experienced one, you understand just how much of a burden they are. Did you know that, in general, kidney stones have the highest prevalence rate^[1] of 19.7% in males older than eighty? There is a lesser-known type of kidney stone called a staghorn kidney stone.

These formidable stones pose significant challenges and often require specialized treatment to address their complications. Dealing with staghorn kidney stones can be quite intricate, demanding the utmost care and attention from healthcare professionals. In this article, we will provide insight into all there is to know about staghorn kidney stones. You will also learn effective treatment options on how to get rid of kidney stones and gain relief.

What Is A Staghorn Kidney Stone?

Staghorn kidney stones are named for their resemblance to the antlers of a stag. They are large, branching stones that form within the kidneys. They are primarily composed of struvite, a mineral that forms in alkaline urine.

These stones often surface because of recurrent urinary tract infections caused by specific bacteria. The bacteria produce an enzyme called urease, which breaks down urea and creates an alkaline environment that promotes the formation of struvite stones.

As a result, the staghorn stones can rapidly grow within the kidney, extending their numerous branches into the renal pelvis and calyces.^[2] These are regions of the kidney that drain into the ureter, so a Staghorn kidney stone in these locations could ultimately lead to congestion of the entire kidney.

Staghorn Kidney Stone: Symptoms

Several symptoms typically accompany staghorn renal stones. These symptoms include:

• Fever.
• Pain. 
• Hematuria.
• Urinary tract infections.
• Blockage.

Fever

When staghorn renal stones^[3] block the urinary tract, there is an increased risk for infections along that path. The body’s natural response to infection is a fever. This may lead to further disruption in the body resulting in the production of chills.

Intensity & Duration Of Pain:

Another primary symptom of staghorn kidney stones is severe and persistent pain. The pain typically starts from the back or side and can move to the lower abdomen and groin. It may come in waves and vary in intensity, causing huge discomfort.

Hematuria (Blood in Urine)

Staghorn kidney stones can lead to blood in the urine, a condition known as hematuria.^[4] The urine may appear pink, red, or brownish because of the blood. Hematuria is an alarming symptom and should never be ignored, as it may be a sign of kidney damage or infection.

Urinary Tract Infections

Staghorn kidney stones are often associated with recurrent urinary tract infections. The stones provide a breeding ground for bacteria, leading to frequent infections. 

Symptoms of UTIs include:

• A burning sensation during urination.
• Increased urinary frequency.
• Cloudy or foul-smelling urine.

Obstruction & Urinary Blockage:

Because of the large size and intricate shape of kidney stones, patients with staghorn calculi can have obstructed urine flow. This obstruction may cause urinary blockage, leading to difficulty urinating, decreased urine output, or even a complete inability to pass urine. As a result of urine not leaving the kidney, Staghorn kidney stones can also result in kidney swelling and potential kidney damage.

Staghorn Kidney Stone: Causes & Risk Factors

You can prevent Staghorn kidney stones if you understand the factors that cause them. Here are some of the primary causes.

Urinary Stasis 

This condition is also known as urinary retention. It occurs when urine cannot fully leave the bladder therefore some urine is left resting in the bladder. This kind of environment promotes the formation of Staghorn kidney stones.

Fluctuating Anatomical Factors 

Some people are genetically predisposed to staghorn kidney stones. This may be from anatomical abnormalities in their urinary tract or certain metabolic disorders.

Age

The risk of developing staghorn kidney stones increases with increasing age.

Staghorn Kidney Stone Diagnosis 

Staghorn kidney stones are sometimes called silent stones because of their lack of symptoms. They are often incidentally discovered during routine health examinations.

Some individuals may experience sudden pain as the stone passes through the urinary tract. In this case, medical attention becomes necessary.

Symptoms such as blood in the urine and acute abdominal or side pain should prompt further testing, including an ultrasound or CT scan, to confirm a stone. These imaging techniques provide healthcare providers valuable information regarding the stone’s size and location.

In emergencies where a kidney stone is suspected, a CT scan is required. Performing the scan swiftly and precisely promotes an accurate evaluation and timely medical intervention.

Staghorn Kidney Stone Treatments

The treatment options for staghorn stones depend on factors such as the size, location, composition of the stone, as well as the individual’s overall health. Conservative management of kidney stones may be an option depending on those factors, however stones that are greater than 10mm require a procedure for their removal.^[5]

Another way to prevent total kidney damage is to break down uric acid stones and magnesium ammonium phosphate fragments while still small. Here are some common treatments^[6] for staghorn kidney stones.

Extracorporeal Shock Wave Lithotripsy

This non-invasive staghorn kidney stone removal procedure uses shock waves to break the stone into smaller fragments, making it easier to pass through the urinary tract.

Percutaneous Nephrolithotomy 

In this procedure, a small incision is made in the back, and a nephroscope is inserted to remove or break up the stone. It is often used for larger or more complex stones.

Ureteroscopy 

Here, the professional inserts a thin tube through the urethra and bladder to reach the stone in the kidney. The stone can then be removed or made smaller using laser energy. If fragmented, the stone then has the ability to continue passing through the urinary tract where it can be excreted.

Open Surgery

In rare cases where other treatments are not possible or effective, a staghorn kidney stone surgery may be necessary. An incision is made in the abdomen or back to access the stone and complete its removal.

Conclusion

Staghorn kidney stones pose significant health challenges that require prompt assessment and management. These large renal calculi^[7] can lead to severe complications, including kidney damage and recurrent infections. Early detection is crucial, and individuals with risk factors should be vigilant about regular check-ups and screenings.

Frequently Asked Questions