Intrarenal nephrolithotomy and reconstruction of the solitary kidney.

There were 30 patients with solitary kidneys containing staghorn claculi who have been subjected to nephrolithotomy with extensive plastic revision of strictured calices using local renal hypothermia. These patients have been followed for 8 months to 16 years and all have had a recent in-hospital evaluation of renal function and recurrent stone formation. No surgical mortality occurred (death within 3 months of operation). Seven patients have died postoperatively, only 1 of whom had associated progressive deterioration of renal function as a contributory cause of death. It is concluded that surgical removal of calculi from a solitary kidney is a relatively safe procedure that results in significant improvement in the patient's well being. The degree of improvement is of such a nature that it may be equated to "cure of the disease" in 63 per cent of the patients.