Related Experiment Videos
Urolithiasis in horseshoe kidneys: therapeutic management
A Lampel1, M Hohenfellner, D Schultz-Lampel
1Department of Urology, University of Witten/Herdecke, Medical School, Klinikum Barmen, Wuppertal, Germany.
Objectives:
We sought to compare the results of different therapeutic strategies in patients with horseshoe kidneys and urolithiasis.
Methods:
The records of 47 patients (28 male, 19 female; mean age, 42 years) with horseshoe kidney treated for urolithiasis from 1983 to 1994 were reviewed retrospectively and follow-up studies of 38 of 47 patients were obtained after 7 to 122 months (mean, 79).
Results:
Open surgery was performed in 6 patients with ureteropelvic junction obstruction; 1 required nephrectomy of a nonfunctioning right kidney and the other 5 are stone free. Percutaneous nephrolithotomy (PNL) was performed in 4 patients with normal drainage and a moderate to large stone burden; 3 became stone free and the other required extracorporeal shock-wave lithotripsy (ESWL) secondarily. In the remaining 37 patients with normal drainage and a small to moderate stone burden, ESWL achieved a 100% disintegration rate and a 76% stone-free rate.
Conclusions:
The presence of anatomic obstruction will necessitate open surgery for urolithiasis in patients with horseshoe kidney; however, in patients with normal urinary drainage PNL or ESWL can be considered, either singly or as a part of combination therapy. When management is tailored to the individual patient's needs, results of stone treatment can be equivalent to those in normal kidneys.