Bivalve nephrolithotomy in kidneys with ileal ureter

Area of Science:

• Nephrology
• Urology
• Surgical Techniques

Background:

• Managing staghorn calculi in patients with prior renal surgery and ileal ureter presents unique challenges.
• Previous surgical interventions and the presence of an ileal conduit can complicate standard stone removal procedures.

Observation:

• Two patients with recurrent staghorn nephrolithiasis and a history of ileal ureter construction were treated.
• The surgical approach involved in situ bivalve nephrolithotomy utilizing local hypothermia and anatrophic nephrotomy.

Findings:

• Bivalve nephrolithotomy under local hypothermia was successfully performed for staghorn calculi in kidneys with prior operations and an ileal ureter.
• This specific technique was deemed most appropriate due to the potential difficulties and risks associated with alternative procedures, particularly concerning the pelvioileo-anastomosis.

Implications:

• This surgical management strategy offers a viable solution for complex staghorn stone cases in compromised renal systems.
• The findings suggest that localized hypothermia and anatrophic nephrotomy can be safely employed, preserving the integrity of the urinary conduit.