Laparoscopic pyelovesicostomy for giant hydronephrosis in a solitary kidney

Pyelovesicostomy has rarely been described in the literature. Most of the time this procedure has been performed in cases of ureteral obstruction in an ectopic kidney or in a transplanted kidney. We report the case of a 16-year-old male who presented with a history of large abdominal swelling and pain. On investigation he was found to have a solitary right kidney with giant hydronephrosis and to be in renal failure. An initial percutaneous nephrolithotomy diversion was performed followed 1 month later by right laparoscopic pyelovesicostomy. The postoperative period was uneventful. We describe laparoscopic pyelovesicostomy in the management of giant hydronephrosis for the first time. Our case illustrates that laparoscopic pyelovesicostomy is a feasible option in the management of giant hydronephrosis.