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Lee, You, Han, Jeong, Choi, and Oh: Retroperitoneoscopic Nephrectomy for a Horseshoe Kidney with Unilateral Severe Hydronephrosis and Ureteral Hypoplasia
Original Article

Korean J Urol 2009;50(5):512-515.

Published online: 19 January 2009

DOI: https://doi.org/10.4111/kju.2009.50.5.512

Retroperitoneoscopic Nephrectomy for a Horseshoe Kidney with Unilateral Severe Hydronephrosis and Ureteral Hypoplasia

Jung Woo Lee, Seung Hyun You, Dong Yup Han, Hee Jong Jeong, Doo Young Choi1, Yeon Kyun Oh1

1Departments of Urology, Pediatrics, Wonkwang University School of Medicine, Iksan, Korea

Correspondence to: Hee Jong Jeong Department of Urology, Wonkwang University School of Medicine and Hospital, 344-2, Shinyong-dong, Iksan 570-711, Korea TEL: 063-859-1332 FAX: 063-842-1455 E-mail: uro94c@wonkwang.ac.kr

Received 17 November 2008       Accepted 24 February 2009

Copyright © 2009 The Korean Urological Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A horseshoe kidney is the most common renal fusion anomaly. It is well known that horseshoe kidneys may be associated with many urological problems, including calculi, vesicoureteral reflux, and ureteropelvic junction obstruction. However, a horseshoe kidney with unilateral severe hydronephrosis and ureteral hypoplasia is very rare. We report an 11-year-old female who underwent a retroperitoneoscopic nephrectomy for a horseshoe kidney with severe hydronephrosis and unilateral ureteral hypoplasia.

Keywords: Hydronephrosis, Ureter

REFERENCES

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Fig. 1
Imaging studies. (A) and (B) enhanced computed tomography scan, transverse and coronary images, showing a horseshoe kidney with very large hydronephrosis of the left kidney. (C) The 99mTc-MAG3 renal scan showed decreased renal uptake. (D) Insertion of a percutaneous nephrostomy was performed to reduce the size of the hydronephrosis and mark the site so that it could be easily seen during the operation.
kju-50-512f1.tif
Fig. 2
Intraoperative retroperitoneoscopic nephrectomy procedure for a horseshoe kidney with severe hydronephrosis due to unilateral ureteral hypoplasia. (A) The percutaneous nephrostomy tube was checked. (B) The Gerota's fascia was opened and the kidney was freed. (C) Thread-like hypoplasia of the ureter was seen. (D) Renal arteries and veins were clipped and cut. (E) The isthmus was divided by ultrasonic scissors (SonosurgⓇ). (F) The specimen was put into a LapSacⓇ and extracted.
kju-50-512f2.tif
Fig. 3
Gross findings. (A) Excised kidney showing severe hydronephrosis. (B) Distal ureteral hypoplasia (arrow).
kju-50-512f3.tif
Fig. 4
Pathologic findings. (A) H&E, x100, Nonfunctioning kidney with chronic inflammation. (B) H&E, x200, A few normal nephrons (arrow).
kju-50-512f4.tif
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