Branched renal calculi.

Surgical operation on 30 kidneys was carried out for branched renal calculi, with no operative mortality. Of 23 kidneys in which conservative surgical procedures were used, 83 percent are now stone-free. When all stones were successfully removed, cultures of urine were sterile in 80 percent of cases, but when fragments remained, no patient was infection-free. It was found that impaired renal function need not be a contraindication to surgical operation, and indeed that in five of seven patients with impaired renal function, serum creatinine levels either remained stable or improved. We believe that surgical removal is the most conservative management of branched renal calculi.