Laparoscopic pyeloplasty in a solitary kidney

A 40-year-old male presented with right-sided abdominal pain and no lower urinary tract symptoms. Examination was unremarkable, apart from mild right renal angle tenderness.

Renal function, full blood count and C-reactive protein levels were all normal. Ultrasound of renal tract, abdominal computed tomography (CT) and (99m)Tc-mercaptoacetyltriglycine (MAG3) renogram confirmed ureteropelvic junction obstruction.

The ureteropelvic junction obstruction of the right kidney was identified, with a crossing lower pole renal vessel as the possible cause. An absent left kidney was also noted.

Laparoscopic transperitoneal dismembered Anderson-Hynes pyeloplasty was performed, with posterior transposition of the crossing lower pole vessel.