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Endopyelotomy in horseshoe kidneys

K Nakamura¹, S Baba, H Tazaki

¹Department of Urology, Isehara Kyodo Hospital, Kanagawa, Japan.

Journal of Endourology

|June 1, 1994

Summary

Endopyelotomy effectively treats ureteropelvic junction obstruction in horseshoe kidneys. This minimally invasive procedure offers a safe and successful alternative for patients with complex renal anatomy.

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Area of Science:

Urology
Minimally Invasive Surgery
Nephrology

Background:

Horseshoe kidneys present unique challenges for treating ureteropelvic junction (UPJ) obstruction due to anatomical malrotation.
Previous surgical interventions like open pyeloplasty may fail, necessitating alternative treatment options.

Observation:

Three patients with horseshoe kidneys and UPJ obstruction underwent endopyelotomy.
One patient had a history of failed open pyeloplasty; two had primary obstruction with associated caliceal calculi.
A specialized technique using a cold knife was employed to address the ventromedial wall stenosis.

Findings:

All three patients experienced symptomatic improvement following endopyelotomy.
Two patients demonstrated sustained improvement in renal function, confirmed radiographically over extended follow-up periods (34 and 52 months).
A 14F endopyelotomy stent was used in two patients for 6 weeks post-procedure.

Implications:

Endopyelotomy is a safe and highly effective treatment for UPJ obstruction in the complex anatomy of horseshoe kidneys.
This minimally invasive approach can achieve durable functional outcomes, even in cases with prior surgical failure.
The findings support endopyelotomy as a viable therapeutic option for selected patients with horseshoe kidney anomalies.

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