Skip to main content

Advertisement

SpringerLink
Log in

Laparoscopic nephrolithotomy in a patient with crossed fused renal ectopia

  • Case Study
  • Published:

From Nature Reviews Urology

View current issue Sign up to alerts

Abstract

Background. A 32-year-old man was referred to a tertiary care center for stone management. The patient had initially presented to his primary physician 3 months earlier with right flank pain of 2 month's duration. Abdominopelvic ultrasonography and intravenous urography had revealed left-to-right crossed fused renal ectopia with a 25 mm opaque stone in the crossed kidney. The patient had received two sessions of extracorporeal shock wave lithotripsy, which had failed to remove the renal stone.

Investigations. Noncontrast CT, blood tests (hemoglobin and creatinine levels), abdominopelvic ultrasonography and intravenous urography.

Diagnosis. Left-to-right crossed fused ectopia with a 25 mm opaque renal stone in the anomalous kidney.

Management. The patient underwent laparoscopic nephrolithotomy to remove the renal stone. Intravenous urography and abdominopelvic ultrasonography 1 month after surgery confirmed that the patient was stone free and had functional renal units. The patient will be followed up every 3 months with abdominopelvic ultrasonography for early detection of stone recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1: Imaging of the crossed fused renal ectopia.
Figure 2: Position of the crossed fused kidney.
Figure 3: Laparoscopic nephrolithotomy.

References

  1. Bauer, S. B. in Campbell-Walsh Urology (eds Wein, A. J. & Kavoussi, L. R.) 3269–3304 (Saunders Elsevier, Philadephia, 2007).

    Google Scholar 

  2. Watanabe, T. Reflux nephropathy in a patient with crossed renal ectopia with fusion. Pediatr. Nephrol. 17, 617–619 (2002).

    Article  Google Scholar 

  3. Gur, U., Yossepowitch, O. & Baniel, J. Transitional cell carcinoma in a fused crossed ectopic kidney. Urology 62, 748 (2003).

  4. Collura, G., De Dominicis, M., Patricolo, M. & Caione, P. Hydronephrosis due to malrotation in a pelvic ectopic kidney with vascular anomalies. Urol. Int. 72, 349–351 (2004).

    Article  CAS  Google Scholar 

  5. Gleason, P. E., Kelalis, P. P., Husmann, D. A. & Kramer, S. A. Hydronephrosis in renal ectopia: incidence, etiology and significance. J. Urol. 151, 1660–1661 (1994).

    Article  CAS  Google Scholar 

  6. Singer, A., Simmons, M. Z. & Maldjian, P. D. Spectrum of congenital renal anomalies presenting in adulthood. Clin. Imaging 32, 183–191 (2008).

    Article  Google Scholar 

  7. Gaur, D. D., Trivedi, S., Prabhudesai, M. R., Madhusudhana, H. R. & Gopichand, M. Laparoscopic ureterolithotomy: technical considerations and long-term follow-up. BJU Int. 89, 339–343 (2002).

    Article  CAS  Google Scholar 

  8. Segura, J. W. et al. Nephrolithiasis Clinical Guidelines Panel summary report on the management of staghorn calculi. The American Urological Association Nephrolithiasis Clinical Guidelines Panel. J. Urol. 151, 1648–1651 (1994).

    Article  CAS  Google Scholar 

  9. Preminger, G. M. et al. Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J. Urol. 173, 1991–2000 (2005).

    Article  Google Scholar 

  10. Nadu, A., Schatloff, O., Morag, R., Ramon, J. & Winkler, H. Laparoscopic surgery for renal stones: is it indicated in the modern endourology era? Int. Braz. J. Urol. 35, 9–17 (2009).

    Article  Google Scholar 

  11. Larré, S. et al. A report of unusual crossed fused renal ectopia and minimal invasive management of calculi. Surg. Radiol. Anat. 29, 393–395 (2007).

    Article  Google Scholar 

  12. Tunc, L. et al. Stones in anomalous kidneys: results of treatment by shock wave lithotripsy in 150 patients. Int. J. Urol. 11, 831–836 (2004).

    Article  Google Scholar 

  13. Siegel, Y. I. & Lingeman, J. E. Percutaneous transilial access for stone removal in crossed fused renal ectopia. Urology 42, 82–85 (1993).

    Article  CAS  Google Scholar 

  14. Ghosh, B. C., DeSantis, M., Kleyner, Y. & Zak, Y. Crossed fused renal ectopia with calculi. J. Am. Coll. Surg. 206, 753 (2008).

  15. Matlaga, B. R. et al. Percutaneous nephrolithotomy for ectopic kidneys: over, around, or through. Urology 67, 513–517 (2006).

    Article  Google Scholar 

  16. Gupta, N. P., Mishra, S., Seth, A. & Anand, A. Percutaneous nephrolithotomy in abnormal kidneys: single-center experience. Urology 73, 710–714 (2009).

    Article  CAS  Google Scholar 

  17. Modi, P., Goel, R. & Dodia, S. Case report: laparoscopic pyeloplasty with pyelolithotomy in crossed fused ectopia. J. Endourol. 20, 191–193 (2006).

    Article  Google Scholar 

  18. Romero, F. R. et al. Laparoscopic heminephrectomy for renal cell carcinoma in cross-fused ectopic kidney. Urology 69, 779.e11–779.e13 (2007).

    Article  Google Scholar 

  19. Kumar, S. et al. Laparoscopic heminephrectomy in L-shaped crossed fused ectopia. J. Endourol. 22, 979–983 (2008).

    Article  Google Scholar 

  20. Simforoosh, N. et al. Laparoscopic anatrophic nephrolithotomy for managing large staghorn calculi. BJU Int. 101, 1293–1296 (2008).

    Article  Google Scholar 

Download references

Acknowledgements

We thank Ehsan Ghanbarifard and Mahboobeh Kharestani for their help in editing the video, capturing images for the figures and drawing Figure 2a and Karen Shashok (AuthorAID in the Eastern Mediterranean) for improving the use of English in the manuscript.

Author information

Authors and Affiliations

  1. Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran

    Alireza Aminsharifi, Reza Niroomand, Mohsen Kroup & Mohammad Mehdi Hosseini

Authors
  1. Alireza Aminsharifi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Reza Niroomand
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohsen Kroup
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohammad Mehdi Hosseini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alireza Aminsharifi.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aminsharifi, A., Niroomand, R., Kroup, M. et al. Laparoscopic nephrolithotomy in a patient with crossed fused renal ectopia. Nat Rev Urol 6, 675–679 (2009). https://doi.org/10.1038/nrurol.2009.198

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrurol.2009.198

  • Springer Nature Limited

Search

Navigation