Investigator aimed to analyze the clinical efficacy and safety of multiple tracts PCNL as one step therapy to treat the staghorn stones or multiple calyceal calculi which are inaccessible by single tract

Staghorn calculi are branched stones either partial or complete occupying the pelvis and one or more of the renal caliceal system that is detected by non contrast computrized tomography (NCCT) and plain on kidney, ureter, urinary bladder (KUB). An untreated staghorn calculus over time can damage the kidney and deteriorate its function and /or cause life threatening sepsis.

Total stone clearance is an important goal to eradicate any infective focus, relieve obstruction and preserve the kidney function.

Based on American Urological Association (AUA) guideline, PCNL is the most effective, safest and minimally invasive treatment option compared to open surgery

Inclusion Criteria:

1. Adult patients more than 18 years old.
2. Patients with staghorn stone (partial, complete).
3. Patients with multiple calyceal calculi which are inaccessible by single tract.

Exclusion Criteria:

1. Patients under 18 years old.
2. Patients with renal anomalies.
3. Patients with only function kidney.
4. Patients with distal ureteric obstruction.
5. Patients with radiolucent stone.
6. Patients with febrile urinary tract infection.
7. Patients with abnormal coagulopathy state.
8. Patients refused to participate in this study.
9. pregnancy.
10. Musculoskeletal deformity.