Staghorn Kidney Stones

Have you ever heard of staghorn kidney stones? Unlike small kidney stones that may pass with minimal symptoms, staghorn stones are often associated with repeated urinary tract infections, obstruction, and even acute kidney injury.

In this guide, we’ll discuss what staghorn stones are, what causes them, how they’re diagnosed and treated, and what you can do to prevent them. If you’re concerned about kidney stones, call Urology of Greater Atlanta or schedule an appointment online today. 

What Are Staghorn Kidney Stones?

Staghorn kidney stones are a type of large kidney stone that occupies a significant portion of the renal pelvis and the branched system of the kidney.

These stones typically form as a result of infection or underlying metabolic conditions. A staghorn stone may begin as a small kidney stone that progressively enlarges or as an infection stone due to bacteria in the urinary tract. Over time, stone growth continues until the stone occupies a significant portion of the kidney.

They are often composed of:

• Struvite stones, made from magnesium ammonium phosphate in response to urease-producing bacteria
• Calcium oxalate stones, the most common type of calcium-based stones
• Calcium phosphate stones, often found in people with alkaline urine
• A mix of calcium carbonate apatite, along with struvite.

The Symptoms of Staghorn Kidney Stones

While some kidney stones may be asymptomatic until they grow large enough to block urine flow, staghorn stones tend to produce symptoms sooner due to their size and complexity. These may include:

• Persistent pain in the side, abdomen, groin, or lower back
• Hematuria (blood in urine)
• Fever and chills, particularly with a urinary tract infection
• Frequent or repeated infections
• Cloudy or foul-smelling urine
• Painful urination or difficulty urinating

The Causes of Staghorn Kidney Stones

Staghorn stones are often caused by recurrent urinary tract infections that lead to the accumulation of mineral deposits, ultimately forming the stones over time. Other causes include the following:

• Unusual anatomy that lends itself to stone formation
• Urinary tract obstructions
• Long-term catheter use
• Prior urinary diversion procedure
• Neurogenic bladder
• Long-term untreated kidney stones

Who is Likely to Get Staghorn Kidney Stones?

Certain risk factors increase the likelihood of developing staghorn kidney stones. Some of the kidney stone risk factors include:

• History of urinary tract infections
• Congenital urinary tract malformations
• Metabolic disorders
• Family history of kidney stones
• Drinking insufficient amounts of water
• Assigned female at birth

Types of Kidney Stones

Understanding the types of kidney stones can aid in both treatment and prevention. Common varieties include:

• Calcium oxalate stones: Most frequent and form in people with high urine calcium levels or high oxalate intake
• Calcium phosphate stones: More likely to occur in individuals with alkaline urine
• Struvite stones: Also called infection stones, caused by UTIs and made of magnesium ammonium phosphate
• Uric acid stones: Develop in acidic urine and are often associated with diets high in purines
• Cystine stones: Rare and result from a genetic disorder affecting cystine processing

Diagnosis of Staghorn Kidney Stones

To diagnose staghorn kidney stones, healthcare providers use imaging and lab tests to assess the size, composition, and impact on the urinary system. Diagnostic steps may include:

• CT scan: The most accurate imaging method to detect stone-forming patterns
• Ultrasound or X-ray: Useful for tracking stone growth or spotting calcium stones
• Urinalysis: Checks for infection, uric acid, oxalate, and low urinary citrate
• Stone analysis: Identifies stone composition (e.g., calcium phosphate, uric acid stones)

These tools also help evaluate the potential for acute kidney injury or damage to kidney function.

How to Treat Staghorn Kidney Stones

Treating staghorn calculi typically requires active intervention, as these larger stones rarely pass on their own. Depending on the size, location, and stone composition, your doctor may recommend:

1. Shock Wave Lithotripsy (SWL)

This non-invasive technique uses sound waves to break the stone into smaller stones or fragments that can be passed more easily.

2. Percutaneous Nephrolithotomy (PCNL)

This minimally invasive surgery is often the first-line treatment for staghorn kidney stones. A small incision in the back allows the surgeon to access and remove the entire stone. PCNL is especially effective for struvite stones, calcium-based stones, or mixed stones.

3. Open Surgery

Reserved for complex or giant staghorn stones, open surgery allows full removal but involves a longer recovery time. It’s rarely needed today due to advances in PCNL and SWL.

Sometimes, a combination of SWL and PCNL is used to ensure complete stone clearance.

Pain Management

While awaiting treatment or if stones are passing naturally, doctors may prescribe:

• Pain medication to alleviate renal colic
• Alpha blockers to relax the ureter and facilitate passage
• Increased hydration to improve urine flow and help stones pass

However, pain medication alone is insufficient for large kidney stones, such as staghorn calculi.

How to Prevent Staghorn Kidney Stone Recurrences

Preventing staghorn kidney stones and other calcium-based stones involves addressing both stone formation and infection risks. Here are key strategies:

• Stay well-hydrated. Aim for at least 2-3 liters of water daily
• Avoid high-oxalate foods, such as spinach, beets, chocolate, and nuts
• Treat urinary tract infections promptly and thoroughly

Individuals with metabolic disorders or chronic infections are more likely to form kidney stones repeatedly unless underlying issues are addressed.

When to See a Healthcare Provider

After treatment for staghorn kidney stones, contact your provider if you:

• Experience a fever over 100°F
• Have chills or uncontrollable shaking
• Notice worsening bleeding
• Are unable to urinate
• Feel severe or escalating pain

Prompt evaluation is crucial to prevent infection or complications that may impair kidney function.

Get Expert Help for Kidney Stones

Whether you’re dealing with smaller stones, large staghorn stones, or repeated urinary tract infections, Urology of Greater Atlanta is here to help. Our expert team provides personalized treatment plans for every type of kidney stone, helping you regain comfort and protect your long-term kidney function. Call today or request an appointment online to get started.