[Surgical treatment of coral calculi in the renal pelvis].

In the years between 1971 and 1979 in the Department of Urological Surgery of the Municipal Weil Emil Hospital in 16 of the 72 coral calculi filling the renal pelvis primary (so-called uric acid) calculi were found to which lytholysis was applied. Fifty-six cases (secondary calculi) were operated, in the majority by conservative surgery (40 cases), 16 patients were nephrectomized. The incidence of coral stones is twice as high in women as in men. Congestion and infections play the major role in their pathogenesis, hypercalciuria is less frequent. Up-to-date possibilities of examination ensure the proper plan of the operation. Complete removal of the stones, abolishment of congestion and infection and postoperative care are very important in the prevention of relapse. In 21 of the 72 cases congenital malformation as was found as a source of congestion. There are various types of conservative operations. Quite often the renal parenchyma is incised, and in this case the peduncle has to be ligated. By cooling the kidney the hypoxic time can be prolonged quite considerably. In the course of the operation the kidney must be made free of stones as the incidence of relapses is high. Analysis of the removed coral stones showed that 68% of them consisted of carbonate-apatite-struvite.