Urinary Stones in a Horseshoe Kidney with Ipsilateral Ureteral Reimplantation: Case Report
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.
2. Weizer AZ, Silverstein AD, Auge BK, Delvecchio FC, Raj G, Albala DM, et al. Determining the incidence of horseshoe kidney from radiographic data at a single institution. J Urol. 2003;170:1722–6.
3. Muttarak M, Sriburi T. Congenital renal anomalies detected in adulthood. Biomed Imaging Interv J. 2012;8:7.
4. Liatsikos EN, Kallidonis P, Stolzenburg JU, Ost M, Keeley F, Traxer O, et al. Percutaneous management of staghorn calculi in horseshoe kidneys: A multi-institutional experience. J Endourol. 2010;24:531–6.
5. Gómez Pascual JA, Soler Martínez J, García Galisteo E, Díaz Ramírez F, Alvarado Rodríguez A, Blanco Reina F, et al. Extracorporeal shock-wave lithotripsy as treatment of lithiasis in horseshoe kidney. Arch Esp Urol. 2003;56(1):39-44.
6. Prakash G, Sinha RJ, Jhanwar A, Bansal A, Sigh V. Outome of percutaneous nephrolithotomy in anomalous kidney: is it different? Urol Ann. 2017;9:23-26.
7. Gukuk A, Uyeturk U. Usefulness of hounsfield unit and density in the assessment and treatment of urinary stones. World J Nephrol. 2014;6:282-286.
8. Etemadian M, Maghsoudi R, Abdollahpour V, Amjadi M. Percutaneous nephrolithotomy in horseshoe kidney. Our 5-year experience. Urol J. 2013;10:856-60.
9. Jiang K, Tang K, XuH, Chen H, Chen Z. Retroperitoneoscopy Technique-Assisted Percutaneous Nephrolithotomy for Complexity Horseshoe Kidney with Renal Stones. Urol Int. 2016;97:285-291.
10. Emiliani E, Michele T, Audouin M, Traxer O. Modern flexible ureteroscopy in Cohen cross-trigonal ureteral reimplantations, J Pediatr Urol. 2017;13:329-331.
11. Molimard B, Al-Qahtani S, Lakmichi A, Sejiny M, Gil-Diez de Medina S, Carpentier X, et al. Flexible ureterorenoscopy with holmium laser in horseshoe kidneys. Urology. 2010;76:1334–1337.
12. Atis G, Resorlu B, Gurbuz C, Arikan O, Ozyuvali E, Unsal A, et al. Retrograde intrarenal surgery in patients with horseshoe kidneys. Urolithiasis. 2013;41:79–83.
13. Gokce, Mehmet Ilker et al. Comparison of Shock Wave Lithotripsy (SWL) and Retrograde Intrarenal Surgery (RIRS) for Treatment of Stone Disease in Horseshoe Kidney Patients.” International Brazilian Journal of Urology. Int Braz J Urol. 2016;41:96–100.
14. Ding, Jie et al. Flexible Ureteroscopic Management of Horseshoe Kidney Renal Calculi. Int Braz J Urol. 2015;41: 683–689.
15 Ganpule AP, Prashant J, Desai MR. Laparoscopic and robot-assisted surgery in the management of urinary lithiasis. Arab J Urol. 2012;10:32-9.
Copyright (c) 2018 Portuguese Association of Urology
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.