{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T11:36:42Z","timestamp":1773315402174,"version":"3.50.1"},"reference-count":9,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology Case Reports"],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"\n Background:<\/jats:title>\n \n Urolithiasis of transplant kidneys usually encompasses a challenging clinical situation due to specific anatomical conditions and the patients' immunological status. In this case report, we describe the treatment of a rare\n Proteus mirabilis<\/jats:italic>\n matrix staghorn stone applying percutaneous nephrolithotomy in combination with matrix stone extraction by morcellation while utilizing endo-urological equipment designed for transurethral prostate surgery.\n <\/jats:p>\n <\/jats:sec>\n \n Case Presentation:<\/jats:title>\n \n We present the case of a 44-year-old Caucasian woman who had undergone a post-mortal kidney transplant at age 37. After recurrent urinary tract infections, symptomatic obstructions of the transplant ureter, and multiple surgical interventions (73 Double-J stent and nephrostomy placements and three ureter re-implantations), permanent percutaneous nephrostomy drainage was established 6 years after her kidney transplantation. The patient was referred to our department due to recurrent dysfunction of the nephrostomy tube caused by blockage due to stone-matrix material and a staghorn calculus in the transplant kidney's collecting system. Microbiological examination of the stone material retrieved from the nephrostomy tube revealed massive\n P. mirabilis<\/jats:italic>\n contamination. In this work, we present a novel percutaneous technique of matrix stone removal by relying on endoscopic equipment usually employed during prostate surgery by urologists.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Percutaneous matrix stone morcellation is a technically challenging but feasible method that might be considered as a salvage treatment strategy in situations described earlier and in highly selective cases. However, for this extremely rare stone entity and individual clinical presentations, matrix stone morcellation seems to be a reasonable alternative before considering more radical interventions such as open nephrolithotomy. Selection criteria are a very soft stone, large-caliber percutaneous access to the collecting system, and enough space in the collecting system to execute morcellation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/cren.2020.0008","type":"journal-article","created":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T11:04:04Z","timestamp":1592478244000},"page":"209-212","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapy-Refractory Matrix Staghorn in a Kidney Transplant Recipient: Endoscopic Percutaneous Morcellation as a Novel Treatment Option"],"prefix":"10.1177","volume":"6","author":[{"given":"Simon","family":"Hein","sequence":"first","affiliation":[{"name":"Department of Urology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, Freiburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Suarez-Ibarrola","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, Freiburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Gratzke","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, Freiburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arkadiusz","family":"Miernik","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical Center\u2014University of Freiburg, Faculty of Medicine, University of Freiburg, Germany, Freiburg, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,9,17]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.5500\/wjt.v6.i4.790"},{"key":"e_1_3_7_3_2","unstructured":"T\u00fcrk C (Chair) ASV-c Neisius A Petrik A Seitz C Thomas K. Guidelines Associates: Donaldson JF Drake T Grivas N Ruhayel Y. EAU Guidelines on Urolithiasis 2019. 2019. Available at: https:\/\/uroweb.org\/guideline\/urolithiasis\/ (accessed June11 2020)."},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.1994.8.335"},{"key":"e_1_3_7_5_2","first-page":"378","article-title":"V","volume":"48","author":"Gage H","year":"1908","unstructured":"Gage H, , Beal HW. V. Fibrinous calculi in the kidney. Ann Surg, 1908; 48:378\u2013387.","journal-title":"Fibrinous calculi in the kidney. Ann Surg"},{"key":"e_1_3_7_6_2","first-page":"959","article-title":"Staghorn calculus in a renal allograft","volume":"18","author":"Jain AB","year":"1986","unstructured":"Jain AB, , Angrisani L, , McMaster P. Staghorn calculus in a renal allograft. Transplant Proc, 1986; 18:959\u2013962.","journal-title":"Transplant Proc"},{"key":"e_1_3_7_7_2","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/S0272-6386(12)80684-6","article-title":"Infection-induced stone formation in a renal allograft","volume":"24","author":"Hess B","year":"1994","unstructured":"Hess B, , Metzger RM, , Ackermann D, , Montandon A, , Jaeger P. Infection-induced stone formation in a renal allograft. Am J Kidney Dis, 1994; 24:868\u2013872.","journal-title":"Am J Kidney Dis"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2007.06768.x"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-003-0364-8"},{"key":"e_1_3_7_10_2","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/0090-4295(86)90153-6","article-title":"Endourologic approach to transplant kidney","volume":"28","author":"Eshghi M","year":"1986","unstructured":"Eshghi M, , Smith AD. Endourologic approach to transplant kidney. Urology, 1986; 28:504\u2013507.","journal-title":"Urology"}],"container-title":["Journal of Endourology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/cren.2020.0008","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/cren.2020.0008","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/cren.2020.0008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:25:40Z","timestamp":1773249940000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/cren.2020.0008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,1]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,9,1]]}},"alternative-id":["10.1089\/cren.2020.0008"],"URL":"https:\/\/doi.org\/10.1089\/cren.2020.0008","relation":{},"ISSN":["2379-9889","2379-9889"],"issn-type":[{"value":"2379-9889","type":"print"},{"value":"2379-9889","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,1]]}}}