The largest staghorn calculus reported to date, treated by nephron-preserving anatrophic nephrolithotomy

Staghorn calculi occupying the renal pelvis and extending into multiple calyces are associated with infection, progressive renal impairment and eventual loss of renal function if left untreated. Percutaneous nephrolithotomy remains the standard treatment for most staghorn calculi. However, exceptionally large complete staghorn calculi may require multiple access tracts, staged procedures or combined approaches. The largest kidney stone listed by Guinness World Records measures 13.37 cm. We report the complete staghorn calculus to be 13.8 cm on definitive ex vivo assessment, which, to our knowledge, represents the largest staghorn calculus reported to date.