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Aim <p>We report the experience of laparoscopic approach for the treatment of hydronephrosis in patient with superior crossed fused renal ectopia (SCFRE) and pelvic dystopia.</p> Methods <p>A 12-year-old girl presented with episodes of acute obstructive pyelonephritis on the background in context of hydronephrosis and pelvic dystopia of horseshoe kidney. She was carrier of nephrostomy and urethral stents. An excretory urography revealed ureteropelvic junction obstruction (UPJO) of the left kidney and agenesis of the right kidney. The CT revealed that the lower pole of the right kidney was fused with the upper pole of the left kidney. The patient was diagnosed with superior crossed fused renal ectopia with pelvic dystopia and UPJO of the left kidney. In the first stage of treatment, the stents were removed transurethrally and the nephrostomy in the left segment was replaced under ultrasound control. One month later, the 3D laparoscopic pyeloplasty was performed.</p> Results <p>Six months after surgery, the patient was free of urinary tract infections and had normal micturition. A control US examination revealed a reduction in the dimensions of the pelvicalyceal system.</p> Conclusion <p>Careful preoperative assessment is important to clarify the complex anatomy for the surgical treatment of renal malformation in patients with cross-renal ectopia. In this rare malformation, successful pyeloplasty can be performed with minimal trauma using laparoscopy, despite the complex location and anatomy of the kidney.</p>

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Ureteropelvic junction obstruction with superior crossed fused renal ectopia and pelvic dystopia

  • 期刊论文

  • 发表日期：

    2025年6月3日

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  • Oleg S. Shmyrov,
  • Kirill D. Morozov,
  • Hüseyin Özbey,
  • Karine V. Agasyan,
  • Marianna M. Muravyova,
  • Dmitry A. Morozov

摘要

Aim

We report the experience of laparoscopic approach for the treatment of hydronephrosis in patient with superior crossed fused renal ectopia (SCFRE) and pelvic dystopia.

Methods

A 12-year-old girl presented with episodes of acute obstructive pyelonephritis on the background in context of hydronephrosis and pelvic dystopia of horseshoe kidney. She was carrier of nephrostomy and urethral stents. An excretory urography revealed ureteropelvic junction obstruction (UPJO) of the left kidney and agenesis of the right kidney. The CT revealed that the lower pole of the right kidney was fused with the upper pole of the left kidney. The patient was diagnosed with superior crossed fused renal ectopia with pelvic dystopia and UPJO of the left kidney. In the first stage of treatment, the stents were removed transurethrally and the nephrostomy in the left segment was replaced under ultrasound control. One month later, the 3D laparoscopic pyeloplasty was performed.

Results

Six months after surgery, the patient was free of urinary tract infections and had normal micturition. A control US examination revealed a reduction in the dimensions of the pelvicalyceal system.

Conclusion

Careful preoperative assessment is important to clarify the complex anatomy for the surgical treatment of renal malformation in patients with cross-renal ectopia. In this rare malformation, successful pyeloplasty can be performed with minimal trauma using laparoscopy, despite the complex location and anatomy of the kidney.