The place of partial nephrectomy in the management of renal calyceal calculi.

In 416 patients with renal and ureteric calculi other than large staghorns we found that when it was possible to identify the calyx of origin of the stones, the lower poles were involved in 36-6% of males and 40-4% of females. In the follow up of the 115 lower poles originally containing stones the recurrence rate was 17% in those who were merely observed, 56% in those treated by pyelo- or nephrolithotomy, and zero in those treated by partial neprectomy. But when these cases were looked at more closely it was found that recurrences were virtually confined to lower poles which had originally harboured more than one stone, while in those with single stones to start with, the recurrence rate was not significantly different in either of these three groups. Partial nephrectomy should therefore be reserved for selected cases where the stones are originally multiple, or where the lower pole has been severely damaged. It is not necessary for small and single calyceal calculi.