Document Detail


Current management of calculi in horseshoe kidneys.
MedLine Citation:
PMID:  10903072     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess treatment options for calculi in horseshoe kidneys and the impact of extracorporeal shockwave lithotripsy (ESWL) on the management of renal stones. MATERIAL AND METHODS: From June 1971 to January 1998, 52 patients with horseshoe kidneys and calculi received treatment at our Urologic Stone Unit. There were 40 men (77%) and 12 women (23%). Average patient age was 41 years (range: 10-70 years). Clinical onset, treatment received and outcome were evaluated retrospectively. A successful outcome was defined as a patient without residual calculi or with fragments <0.4 cm in size. RESULTS: Clinical onset was mainly low back pain in 37 patients (71%). Eighty-nine stones were treated, i.e. an average of 1.7 treatments per patient. Before the ESWL era (May 1987), we performed two heminephrectomies, 16 pyelolithotomies, 12 pyelolithotomies combined with ureteropyeloplasty and one percutaneous nephrolithotomy. Since the advent of ESWL, seven pyelolithotomies and three pyelolithotomies combined with ureteropyloplasty have been done. ESWL was used to treat 48 calculi. In three cases the patient was placed in the prone position due to difficulties in stone focusing. In 37 cases (77%) patients were either rendered stone-free or had residual fragments <0.4 cm in size. Urinary diversion for obstruction was carried out in two cases (4%). CONCLUSIONS: At present ESWL is the first-choice treatment for calculi in horseshoe kidneys. It involves no significant focusing difficulties and is associated with a low incidence of obstructive complications. Open surgery is indicated in cases of stone-related pyeloureteral stenosis and in the presence of calculi >2-2.5 cm in size.
Authors:
A Collado Serra; R Parada Moreno; F Rousaud Barón; F Monreal Garcia de Vicuña; A Rousaud Barón; J V Rodriguez
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of urology and nephrology     Volume:  34     ISSN:  0036-5599     ISO Abbreviation:  Scand. J. Urol. Nephrol.     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-12-27     Completed Date:  2000-12-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0114501     Medline TA:  Scand J Urol Nephrol     Country:  SWEDEN    
Other Details:
Languages:  eng     Pagination:  114-8     Citation Subset:  IM    
Affiliation:
Fundació Puigvert, Universidad Autónoma de Barcelona, Spain. Urologia@fundacio-puigvert.es
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Female
Humans
Kidney / abnormalities*
Kidney Calculi / complications*,  therapy*
Lithotripsy*
Male
Middle Aged
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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