Urinary Stones in a Horseshoe Kidney with Ipsilateral Ureteral Reimplantation: Case Report

  • Diogo Nunes-Carneiro Serviço de Urologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal
  • Rui Oliveira Serviço de Urologia, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
  • Vítor Cavadas Serviço de Urologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal
Keywords: Kidney/abnormalities, Kidney Calculi, Replantation, Ureteral Obstruction

Abstract

Horseshoe kidney is a common congenital renal anomaly and is often associated with urinary tract infections and renal calculi as a consequence of anatomical changes that impair the efficient drainage of the urine. The treatment of urinary stones in these cases becomes a challenge due to the underlying anatomical abnormalities requiring an adaptation of the techniques normally used for the treatment of renal lithiasis.

We report the case of a 44-year-old woman with a past history of Cohen left ureteral reimplantation due to vesico-ureteral reflux in childhood and renal lithiasis. The patient had two 12 and 10 mm stones in the upper calix of the left hemi-kidney, with a narrow infundibulum.

A flexible ureteroscopy with laser Holmium lithotripsy was performed by placement of a ureteral sheath over the narrowed infundibulum and the patient was left stone-free at the end of the procedure.

It is important, in cases of horseshoe kidney stones, to think and adapt the various techniques available for the treatment of renal lithiasis, and to choose the one that will provide a higher success rate with fewer complications.

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Published
2019-01-19