“…In cases of complete staghorn calculi, we found that an endoscopic approach by PNL often requires several treat ments. Concerning the risks, especially the high propor tion of obstructive pyelonephritides (30%) must be men tioned [3][4][5], ESWL for staghorn calculi, used as mono therapy, is also of limited alternative value to open stone removal because of the length of treatment time [6,7], Therefore we are of the opinion that the treatment of a staghorn calculus by PNL is theoretical possible. Because of the long-lasting therapy and the high proportion of complications, it would be advisable to perform an open operation in these cases.…”