This is a prospective randomized study to compare endoscopic combined intrarenal surgery and PCNL as modalities of treatment for staghorn stones. In terms of efficacy and safety

This is a prospective randomized study to compare endoscopic combined intrarenal surgery and PCNL as modalities of treatment for staghorn stones. In terms of efficacy and safety The efficacy will be studied at stone-free rate While efficacy will be studied using DMSA scan pre- and post-procedures in addition to the safety of each procedure with regard to intra- and post-operative complications,.

Inclusion Criteria:

• Patients are more than 18 and less than 65 years old.
• Patients with renal staghorn stones based on imaging modalities (stones occupying the renal pelvis and extending into at least 2 major calyces).

Exclusion Criteria:

• Patients with renal insufficiency (serum creatinine > 1.6 mg/dl)
• patients with active urinary tract infection.
• Patients with congenital renal anomalies.
• Morbid obesity (BMI > 35 kg/m2).
• Pregnancy.
• Bleeding Coagulopathy.
• Skeletal deformity