Management of upper urinary tract calculi in crossed fused renal ectopic anomaly

Huang,Liang; Lin,Yong; Tang,Zhengyan; Lie,Dongjie; Wang,Zhao; Chen,Hequn; Wang,Guilin

doi:10.3892/etm.2017.5382

Management of upper urinary tract calculi in crossed fused renal ectopic anomaly

Authors:
- Liang Huang
- Yong Lin
- Zhengyan Tang
- Dongjie Lie
- Zhao Wang
- Hequn Chen
- Guilin Wang
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Affiliations: Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China, Institute for Virology, University Hospital of Essen, University of Duisburg‑Essen, D‑45147 Essen, Germany
Published online on: October 27, 2017 https://doi.org/10.3892/etm.2017.5382
Pages: 371-376

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Abstract

The aim of the present study was to summarize the management of upper urinary tract calculi in crossed fused renal ectopia (CFRE). Two patients were retrospectively studied in Xiangya Hospital (Changsha, China) and all relevant literature published in English between 1996 and 2016 was reviewed. All patients, including those reported in the literature, were characterized by age, sex, manifestation, therapy history, ectopic side, stone location, surgery and outcome. The patients had a mean age of 42.3±18.5 years, a male: Female ratio of 5:4 and the ratio of renal ectopic side was 9:8 (left:right). All patients suffered from different degrees of pain on the affected side, with or without hematuria. Up to 89% of patients presented with renal stones. These patients received treatments including conservative management in 2, extracorporeal shock wave lithotripsy (ESWL) in 2, percutaneous nephrolithotomy (PCNL) in 11, laparoscope nephrolithotomy in 1 and retrograde intrarenal surgery (RIRS) in 3. Complete stone clearance was achieved in 14 patients (73.7%). In addition, 3 patients had a history of failed ESWL. No obvious intraoperative or postoperative complications occurred. The results suggested that, for the treatment of CFRE with upper urinary tract calculi, conservative treatment and ESWL are insufficient. PCNL is a safe and effective treatment for renal calculus, and laparoscopic nephrolithotomy is an alternative choice for treating large or staghorn renal stones. RIRS may become the first line of treatment for renal stones (≤3.5 cm) due to its multiple merits, including higher stone‑free rates, minimal invasion and fewer complications.

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