Pune, April 23: Doctors at Manipal Hospital Kharadi successfully treated a complex and high-risk kidney stone case in a female patient with a history of severe post-operative complications. The patient had previously undergone Percutaneous Nephrolithotomy (PCNL) in 2009, which resulted in life-threatening bleeding, multiple blood transfusions, and significant damage to the kidney, with nephrectomy being advised at the time.
The patient had been aware of her kidney stone since 2018, but because of her trauma from earlier treatments, she had not tried surgery despite ongoing symptoms. Over an undetermined period, the patient kept trying to have more consultations until she started experiencing excruciating, ongoing pain for a total of two months before seeking medical attention.
The urology team performed a full evaluation and decided on performing the RIRS (Retrograde Intrarenal Surgery), which is a minimally invasive and incision-free procedure, due to the potential complications with conventional methods. The patient was found to have a complete staghorn calculus (a stone-type that takes the shape of the renal pelvis) with an approximate size of 6.2 x 2.5 cm and made from calcium oxalate monohydrate.
Speaking about the case, Dr Ankit Sharma, Consultant – Urology, Manipal Hospital Kharadi, Pune, said,
“Given the patient’s history of severe complications following PCNL, attempting a similar approach would have carried significant risks of bleeding, infection, and even sepsis. There was also a possibility of requiring multiple staged procedures. In such high-risk scenarios, RIRS offers a safer and more controlled alternative, especially when performed with the right expertise and technology. Although staghorn stones have traditionally been managed with open surgery or PCNL, advancements in endourology now allow us to treat even complex cases using minimally invasive techniques.”
He further added, “In this case, we performed a conventional RIRS with a 65-watt high-power laser to precisely fragment the stone into fine dust particles. The entire procedure lasted approximately 120 minutes and was completed without any significant blood loss. The patient was discharged within 24 hours with a stent in place and was able to resume normal activities within 48 hours.”
The surgery was completed successfully in a single sitting, achieving complete stone clearance without complications. The patient had a smooth recovery, did not require ICU care, and was discharged after a short hospital stay.
This case highlights the growing role of minimally invasive procedures like RIRS in managing complex kidney stones, especially in high-risk patients. Experts emphasize that delaying treatment for kidney stones can lead to serious complications such as kidney damage, infections, sepsis, and even renal failure. Early diagnosis and timely intervention remain crucial.
