Modified percutaneous nephropexy for nephroptosis: Technical description and short-term results
Honglei Liu1, Wenzhi Gao2, Zheng Zhang1
1Department of Urology, Peking University First Hospital-Miyun Hospital, Beijing, China.
Objectives:
Percutaneous nephropexy (PCN) has been demonstrated as a feasible method for treating nephroptosis. This study describes an improved technique for PCN that better addresses the issue of nephroptosis.
Materials And Methods:
We reviewed 4 patients who underwent the improved PCN procedure between January 2021 and January 2023. These patients were diagnosed with nephroptosis, with 1 case having both a narrow ureteropelvic junction and nephroptosis due to a kidney stone, and 3 cases having simple nephroptosis. Patient characteristics, perioperative data, and follow-up results were collected. Surgical success was determined by symptom relief (subjective success) and the absence of kidney descent by intravenous pyelography (objective success).
Results:
Preoperative computed tomography urography showed that all patients had hydronephrosis, with severe hydronephrosis in 75% (3/4) and moderate hydronephrosis in 25% (1/4) of cases. The mean operative time was 63.8 minutes (range, 45-95 minutes), and the mean blood loss was 5 mL (range, 5-50 mL). The mean length of hospital stay was 4.5 days (range, 3-6 days). The mean time to removal of the nephrostomy tube was 2 months (range, 1-4 months). No serious complications (Clavien-Dindo grade ≥3) occurred during or after the procedure. The mean postoperative serum creatinine level was 54.75 μmol/L (range, 43-65 μmol/L). The mean follow-up time was 6.25 months (range, 4-8 months). The objective and subjective success rates were both 100%.
Conclusions:
The improved PCN procedure that was used in this study is feasible and provides a good option for treating nephroptosis.
