Cholesteatoma of the Renal Pelvis Treated by Extracorporeal Surgery and Autotransplantation with Pyelocystostomy

Abstract

We report on a patient who had had recurrent renal stones on the right side for 37 years. At the sixth lithotomy the diagnosis of cholesteatoma of the renal pelvis was discussed. After another recurrence of stones and a pelvic lesion nephrectomy was considered. However, the kidney still had 60 per cent of total renal function and the other kidney also harbored stones. Therefore, extracorporeal exploration was performed. The stones and keratin masses were removed from the pelvis and frozen section showed no malignant changes. The kidney was reimplanted in the ipsilateral iliac fossa with end-to-side anastomosis to the external iliac vessels and a wide direct anastomosis between the pelvis and the bladder. At followup 2 months postoperatively the patient was well. Autotransplantation with pyelocystostomy facilitates free passage of recurrent stones and keratin fragments, and allows for future transurethral control of the renal pelvis. Thus, the procedure is well suited for the treatment of cholesteatoma of the renal pelvis.

Renal Function after Autotransplantation with Direct Pyelocystostomy. Long‐term Follow‐up

“…Frequently recurrent stones of the upper urinary tract despite prophylactic treatment were the indication for the procedure in 7 patients. In this group, 2 had a solitary kidney, both with a staghorn stone; 1 had aplasia of the contralateral kidney and the other had previously undergone nephrectomy because of stones and repeated infections; 3 patients had medullary sponge lesions, cystine stones or a cholesteatoma of the renal pelvis (Henriksson et al, 1983;Pettersson et a/., 1983b).…”