Hi, Surgical excision of the abnormal parathyroid tissue is the definitive therapy for this disease of hyperparathyroidism (most likely primary in your case). The formation of recurrent large calculi (staghorn) may lead to urinary tract obstruction, infection, and loss of renal function. Medical surveillance without operation is still preferred by some physicians and patients, particularly when the patients are more elderly (you are senior.) Concerns about skeletal (severe osteoporosis and high risk of fragility fracture) and renal manifestation (recurrent nephrolithiasis) of the disease favors surgical management. New surgical strategies that feature a minimally invasive approach guided by improved preoperative localization and intraoperative monitoring by PTH assays has lowered the threshold for surgery. Once hypocalcemia signifies successful surgery, patients can be put on a high-calcium intake or be given oral calcium supplements. If you do not opt for surgery, a medical therapy which can be considered is bisphosphonates. It increases bone mineral density significantly without changing serum calcium. Calcimimetics (e.g., cinacalcet) which act via the calcium-sensing receptor, have been used to treat primary hyperparathyroidism in some patients when surgery is unsuccessful or contraindicated. These lower PTH secretion & lower calcium but do not affect bone mineral density. You can consult an Endocrinologist. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Tushar Kanti Biswas, Internal Medicine Specialist