What technique or tool do you use to remove mucinous, infection stones?

In the past, we have performed percutaneous nephrolithotomy to remove mucinous, infection stones. Using the Trilogy device through the nephoscope, to fragment and aspirate stones/mucus was quite successful. Although this is significantly more invasive than standard ureteroscopy, we had a much better chance at complete stone/ mucus removal, which is the key when dealing with infection stones. Although we have not utilized the second-generation CVAC device to remove this type of stone, it may be a...

The most efficient way to remove these stones is percutaneously with an ultrasonic/pneumonic lithotripter such as Trology or Shockpulse. For ureteroscopy, the addition of suction with FANS or CVAC can be a game-changer for these types of stones.

CVAC combined with laser lithotripsy can be effective for mild-moderate cases of matrix stones. For severe cases, I have successfully performed robotic pyelolithotomy with complete clearance of large-volume matrix stones, which can be mechanically extracted with robotic instruments and suction-irrigated out of the renal pelvis and calyces. However, these stones will recur very rapidly if risk factors are not addressed adequately. Multidisciplinary involvement, including nephrology and infectious...