[Multimodal approach to the treatment of staghorn stones in modern clinic].

This lecture is dedicated to increasing stone free rate (SFR) in patients with staghorn renal stones by using a multimodal approach. Percutaneous nephrolithotomy (PCNL) is the "gold standard" for the treatment of this group of patients. Depending on a stone size and complexity, SFR for PCNL varies from 55 to 98%. Due to low SFR, which is a main criterion for the effective procedure, various approaches currently are being suggested. In this lecture, we highlighted the following approaches: multi-access PCNL, a use of a ureteroscope in case of antegrade stone migration, a use of flexible instruments, ureterorenoscopy in combination with PCNL. Various lithotripsy techniques are briefly described. The advantage of ultrasound-guided puncture of the kidney is also discussed.