Anomalies of the Upper Urinary Tract

Shapiro, Ellen; Bauer, Stuart B.; Chow, Jeanne S.

doi:10.1016/b978-1-4160-6911-9.00117-1

Cited by 97 publications

(103 citation statements)

References 407 publications

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“…11 Crossing renal vessels are present in at least 40% of adults with primary UPJO. 1 Highly variable anomalous blood supply to horseshoe kidneys further increases the potential for extrinsic compression of an entrapped ureter. The actual contribution of crossing vessels to obstruction is difficult to demonstrate and much less to quantify, but transperitoneal laparoscopy can provide adequate work space to disengage the ureter and vessels in anticipation of transposing the structures once indicated.…”

Section: Managing Upjo In Horseshoe Kidneysmentioning

confidence: 99%

“…Horseshoe kidneys are frequently associated with other congenital anomalies and ureteropelvic junction obstruction (UPJO). 1 The following factors may contribute to UPJO in horseshoe kidneys: anomalous vascular supply to the kidney, high insertion of the ureter into the renal pelvis, its abnormal course over the isthmus, and its intrinsic pathogenesis. 1 Laparoscopic and robotic pyeloplasty have been successful in treating horseshoe kidneys with acceptable functional results, although study subjects are limited.…”

Section: Introductionmentioning

confidence: 99%

“…1 The following factors may contribute to UPJO in horseshoe kidneys: anomalous vascular supply to the kidney, high insertion of the ureter into the renal pelvis, its abnormal course over the isthmus, and its intrinsic pathogenesis. 1 Laparoscopic and robotic pyeloplasty have been successful in treating horseshoe kidneys with acceptable functional results, although study subjects are limited. [2][3][4] Endopyelotomy is another minimally invasive option, but has displayed inferior outcome.…”

Section: Introductionmentioning

confidence: 99%

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Management of ureteropelvic junction obstruction in horseshoe kidneys by an assortment of laparoscopic options

Shadpour

Akhyari²,

Maghsoudi³

et al. 2015

CUAJ

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Introduction: We report our experience with laparoscopic management of ureteropelvic junction obstruction in horseshoe kidneys. Methods: Between February 2004 and March 2014, 15 patients with horseshoe kidneys and symptomatic ureteropelvic junction obstruction underwent laparoscopic management at our national referral centre. Depending on the anatomy and presence of obtrusive vessels or isthmus, we performed either dismembered, Scardino or Foley YV pyeloplasty, or Hellstrom vessel transposition. Patients were initially evaluated by ultrasonography, then diuretic scintiscan at 4 to 6 months, and followed by yearly clinical and sonographic exams. Results: This study included 11 male and 4 female patients between the ages of 4 to 51 year (average 17.7). The left kidney was involved in 12 patients (80%). Operation time was 129 minutes (range: 90-186), and patients were discharged within 2.8 days (range: 1-6). Although 8 (53.3%) patients had crossing vessels, of which 6 required transposing, the Hellstrom technique was solely used in 3 cases, of which notably 1 case failed to resolve and required laparoscopic Hynes within the next year. Eight cases underwent dismembered pyeloplasty, 2 Foley YV, 1 Scardino flap and 1 required isthmectomy and vessel suspension. At the mean follow-up of 60 (range: 18-120) months, the overall success rate was 93.3%. Conclusions: To our knowledge, this represents the largest report on laparoscopic pyeloplasty for horseshoe kidneys, providing the longest follow-up. Our findings confirm prior reports supporting laparoscopy and furthermore show that despite the prevalence of crossing vessels, transposition alone is seldom sufficient.

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Section: Managing Upjo In Horseshoe Kidneysmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management of ureteropelvic junction obstruction in horseshoe kidneys by an assortment of laparoscopic options

Shadpour

Akhyari²,

Maghsoudi³

et al. 2015

CUAJ

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“…1 Tunc et al, 24 in turn, reported a rate of 92% for stones < 10 mm, but 34% for those greater than 30 mm. 3 Coupled with lower efficiency of ESWL in eliminating larger stones, Ray et al 13 has pointed out that 51% of their patients needed an additional procedure, but that little improvement occurred after the second session, revealing a limitation in the number of attempts that could be made.…”

Section: Discussionmentioning

confidence: 99%

“…Horseshoe kidney (HK) represents the most common fusion anomaly, with an incidence of 0.25%, while the incidence of pelvic kidney varies from 1/2,100 to 1/3,000 and the variance of crossed renal ectopia is 1/1,000. 3 These conditions make it even more challenging to treat urinary lithiasis, with lower success rates in endourologic procedures and increased intraoperative risks due to anatomical differences in renal structure, rotation, and vasculature. 4,5 Extracorporeal lithotripsy (ESWL) and percutaneous nephrolithotripsy (PCNL) are currently the most common treatment methods for kidneys with fusion or position abnormalities.…”

Section: Introductionmentioning

confidence: 99%

Flexible ureterorenoscopy in position or fusion anomaly: Is it feasible?

Astolfi

Freschi

Berti

et al. 2017

Rev. Assoc. Med. Bras.

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Objective: To analyze the results of flexible ureterorenoscopy (F-URS) with holmium laser in the treatment of kidney stones with ectopic and fusion anomalies (horseshoe kidney and rotation anomalies). Method: We reviewed data from 13 patients with fusion and ectopic renal anomalies that underwent F-URS from April 2011 to April 2017. We analyzed demographic and clinical data (age, gender, BMI, anatomical abnormality, location and dimension of the renal calculi) and perioperative data (method of treatment, stone-free rate, number of days with DJ catheter and perioperative complications). Results: The mean stone size was 12.23 +/-5.43 mm (range 6-22mm), located in the inferior (58.33%) and middle (16.76%) calyceal units, renal pelvis (16.67%) and multiple locations (8.33%). All 13 patients were treated with Ho-Yag laser, using dusting technique (25%), fragmentation and extraction of the calculi (58.33%) and mixed technique (16.67%). We did not have any severe perioperative complication. After 90 days, nine patients (75%) were considered stone free. Conclusion: Our data suggest that F-URS is a safe and feasible choice for the treatment of kidney stones in patients with renal ectopic and fusion anomalies.

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Management of Stones in Horseshoe Kidneys

Biyani

Joyce

2018

Smith's Textbook of Endourology

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Anomalies of the Upper Urinary Tract

Cited by 97 publications

References 407 publications

Management of ureteropelvic junction obstruction in horseshoe kidneys by an assortment of laparoscopic options

Management of ureteropelvic junction obstruction in horseshoe kidneys by an assortment of laparoscopic options

Flexible ureterorenoscopy in position or fusion anomaly: Is it feasible?

Management of Stones in Horseshoe Kidneys

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