Open pyelolithotomy in an ectopic kidney: A case report

Abstract

Renal ectopia with stone is a rare case with no specific reported incidence rate. The treatment of kidney stone in ectopic kidneys poses a challenge to urologists. A 48-year-old male presenting with colicky pain on the right flank since one year ago. CT urography revealed an right-crossed renal ectopia and hyperdense lesions (25 × 20 mm and 10 × 10 mm) in the ureteropelvic junction of the right kidney. Under general anesthesia, we performed open pyelolithotomy for the patient and removed two stones completely. Open surgery could be the choice for patients with complex stone burden and associated renal anomalies such as ectopic kidney.

Open Pyelolithotomy in a Pelvic Ectopic Kidney: Case Report and Current Literature Review

“…Although considered historical, open surgery may be the safe alternative with a high stone-free rate to the anomalous kidney with a heavy stone burden, such in our case [17]. This approach is already diminished indications in the present guideline; however, it is still relevant to be implemented in developing countries [18].…”

“…In this case, we found the renal stone in the pelvic kidney on radiological examination preoperatively, and this was affected our Stone configuration and complex stone burden also affected the consideration to perform endoscopic surgery in this case, impacting the stone clearance rate and the need for relook procedure, thus increasing the probability of auxiliary surgery [14]. Although having a high stone-free rate, open surgery also had a higher complication rate than endoscopic modalities [17]. Thus, pre-operative imaging with CT scan is essential to recognize anatomy structure and carefully select the patient.…”

Successful management of ectopic kidney stones in a patient with situs inversus totalis: a rare case report

“…Treatment of ectopic kidney stones (EKS) is considered challenging for the urologist [ 14 , 15 ]. According to the European guidelines of Urology (EGU), non-invasive and minimally invasive treatments such as shock wave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL) represent the first choice in the management of kidney stones.…”

“…In developing countries, the use of open surgery upon the non-invasive or minimally invasive approaches is mostly due to the unavailability of the equipment [ 14 ].…”

“…The results were promising and the patient was discharged without any serious complications. Similar cases underwent open surgery for EKS and no major complications were observed during and after the procedure [ 14 ]. Indeed laparoscopic surgery is a safe and useful method for EKS however in the case of SIT the surgeons might find it difficult to maintain the anatomical orientation [ 22 ].…”