[Current treatment of lithiasis in congenital renoureteral malformations]

To evaluate the treatment of urinary calculi in renoureteral malformations.

From April 1988 to December 2000, we have treated 158 patients with renoureteral malformations (36 horseshoe kidneys, 32 caliceal diverticula, 2 megacaliosis, 2 crossed renal ectopy, 3 polycystosis, 7 hydrocalyx, 24 complete duplex ureter, 18 incomplete duplex ureter, 22 ureterocele, 2 segmental megaureter).

Renoureteral malformations were diagnosed in 158 of 19,000 patients that were treated in our stone unit from April 1988 and December 2000. Horseshoe kidney: 54% of the patients treated by ESWL are stone-free; PNL was performed in 2 patients and conventional surgery in another 2 patients. Caliceal diverticulum: 42% of the patients treated by ESWL are stone-free; 3 patients underwent conventional surgery. Other renal malformations: 62% of the patients treated by ESWL are stone-free. Ureteral malformations: duplex ureter and megaureter: 82% of the patients treated by ESWL are stone-free. Ureterocele: due to the poor results achieved by ESWL, we performed endoscopic transurethral meatotomy.

These results indicate that ESWL alone can be considered to be the treatment of choice for small calculi in patients with renal malformations, although we consider it to be mandatory to perform individual assessment of the urinary tract and stone size in these patients in order to choose the best therapeutic option. The same criteria for the normal urinary tract can be applied in ureteral malformations except ureteroceles, for which we advocate performing endoscopic surgery for stone removal.