Efficacy of the Endoscopic Combined Intrarenal Surgery for the Treatment of a Staghorn Calculus in Crossed Fused Renal Ectopia

Abstract

Background: Crossed fused renal ectopia (CFRE) is an unusual anomaly in which both kidneys lie fused on one side, with double pelvis and ureters draining into both sides of the bladder. Complex renal stones are a considerable challenge to endourologists, and when a staghorn stone is associated with abnormal anatomy, its treatment is even more difficult. Today there is no consensus about the right treatment for complex renal stones in CFRE. So, the objective of this case is to present the efficacy of the endoscopic combined intrarenal surgery (ECIRS) for the treatment of a staghorn renal stone in one patient with CFRE. Case Presentation: We described a case of a 23-year-old man with prolonged lasting and pain on the left flank associated with intermittent gross hematuria. Enhanced CT revealed a crossed fused kidney on the left side, drained by an intercommunicating pelvis and a single ureter, with a staghorn stone wholly occupying both renal units. The patient was effectively treated by one single session of ECIRS. Conclusion:The ECIRS is a good alternative to consider in patients with CFRE that have a staghorn calculus with a reasonable success rate.

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

“…It is important to note that staghorn nephrolithiasis with urinary tract anomalies increases the complexity of the surgery for a urologic surgeon and the use of ECIRS, in such cases, can not only reduce the number of complications by simplifying access to UUT, but also improve performance by increasing one-stage SFR [37].…”