Flexible Ureteroscopic Management of Horseshoe Kidney Renal Calculi

Abstract

Purpose:To evaluate the clinical efficacy of flexible ureteroscope (F-URS) combined with holmium laser lithotripter in treating renal calculi in horseshoe kidney.Materials and Methods:From November 2010 to December 2013, the medical history and charts of sixteen patients (mean age 42.9±11.6 years, range 26-66 years), including 13 males and 3 females were analyzed retrospectively. Mean stone burden was 29±8 mm (range 17-42 mm2). Mean stone digitized surface area (DSA) was 321±94 mm2 (range 180-538 mm2). Under spinal anesthesia in a modified lithotomy position with the head down, rigid ureteroscope was placed firstly into the ureter to reach the level of the pelvis, a zebra guide wire was inserted and following the removal of the rigid ureteroscope, an ureteral access sheath was positioned along the guide wire, then passed the URF P-5 flexible ureteroscope into the renal cavities over the guidewire. After locating the stones, holmium laser lithotripsy was performed.Results:The average operative time was 92±16 minutes (range 74-127 min.). No major complications were encountered. Ten patients obtained stone-free status with one session, four obtained stone-free status after two sessions. Single session stone-free rate was 62.5%, overall stone-free rate was 87.5%. Two patients have small residual stones in the lower pole.Conclusions:F-URS combined with holmium laser lithotripter and nitinol basket, is safe and effective in dealing with moderate stone diameter (<30 mm) in HSKs with high clearance rates and low complication rates.

Massive Renal Replacement Lipomatosis With Foci of Xanthogranulomatous Pyelonephritis in a Horseshoe Kidney

“…Impaired drainage of the collecting system and associating ureteropelvic obstruction predispose the patient to urinary tract infection and urolithiasis 4 . In our case, the patient had undergone nephrolithotomy once on the right side of horseshoe kidney, but no residual renal calculi were found.…”

Outcomes of ureteroscopy for stone disease in anomalous kidneys: a systematic review

“…The mean operative time was 61.3 min (range 14-185 min). While six studies report a post-operative stent placement in all of their patients [13,14,19,21,22,26], in the remaining studies this varied from 46.2 to 84% and was at the surgeon's discretion [15][16][17][23][24][25]. The mean hospital stay across studies was 1.7 days (range 0.5-9 days) ( Table 4).…”

“…Ding et al [19] Post-operative pyrexia n = 3 None Blackburn et al [20] Complications not reported Complications not reported Gokce et al [21] Haematuria n = 3 Post-operative pyrexia n = 1…”

“…Ding et al [19] reviewed the efficacy of FURS in 16 patients with HSK. Semirigid URS and UAS were used in all patients.…”

Appendix graft as a ureter substitution in recurrent ureter stenosis in horse -shoe kidney; a case report

“…Horse shoe kidney occurs in 0.25% of the population, or about 1 in 400 persons (1). Previously, up to one-third of individuals with horseshoe kidney had hydronephrosis secondary to UPJ obstruction (8). In the modern era, horseshoe kidneys are frequently discovered incidentally, and their apparent hydronephrosis often shows a non-obstructed pattern on radionuclide scanning (9).…”