Giant hydronephrosis due to uretero-pelvic junction obstruction (UPJO) is rare and usually the treatment is nephrectomy. When renal salvage is required, reconstruction of the UPJ alone is usually inadequate to improve drainage from the pelvicalyceal system. Various open surgical techniques have been described to improve gravity-assisted drainage from the giant hydronephrotic kidney. We describe, for the first time, a complete laparoscopic approach for pyeloplasty combined with nephroplication and nephropexy.
Xanthogranulomatous pyelonephritis (XGP) is invariably associated with urinary tract obstruction, infection and nephrolithiasis. We report an unusual case of XGP occurring in an immunosuppressed patient in the absence of either urinary obstruction or nephrolithiasis, presenting as a diagnostic dilemma, and highlighting the possible role of glucocorticoid immunosuppression towards its pathogenesis.
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