Urolithiasis in horseshoe kidneys: therapeutic management.

Abstract:

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.

journal_name

Urology

journal_title

Urology

authors

Lampel A,Hohenfellner M,Schultz-Lampel D,Lazica M,Bohnen K,Thürof JW

doi

10.1016/s0090-4295(99)80412-9

subject

Has Abstract

pub_date

1996-02-01 00:00:00

pages

182-6

issue

2

eissn

0090-4295

issn

1527-9995

pii

S0090429599804129

journal_volume

47

pub_type

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