Abstract
Laparoscopic dismembered pyeloplasty for ureteropelvic junction (UPJ) obstruction
is considered to be a routine procedure in many pediatric surgical centers. UPJ obstruction
is known to be associated with horseshoe kidney and several reports on successful
laparoscopic repair in such cases exist.
The case of a 9-month-old girl with Turner syndrome is reported. A horseshoe kidney
with grade 4 hydronephrosis on the left side was diagnosed by ultrasound during the
neonatal period. MAG3 diuretic renography and dynamic magnetic resonance imaging nephrography
revealed a differential renal function of 31% and 69% on the left and right side,
respectively. No drainage from the left renal pelvis could be demonstrated.
Laparoscopy showed a combined UPJ obstruction and a calyceal diverticulum with a narrow
infundibulum of the upper pole calices on the left side of the horseshoe kidney. Laparoscopic
dismembered pyeloplasty and an additional infundibulopelvic anastomosis was performed.
No intraoperative complications occurred. The immediate postoperative course was uneventful.
Unobstructed drainage and stable differential renal function on the left side could
be demonstrated on MAG3 diuretic renography 6 weeks postoperatively.
In conclusion, laparoscopic repair of complex malformations of the upper urinary tract
is feasible and leads to good functional outcome in selected cases.
Keywords
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Article info
Publication history
Published online: June 07, 2010
Accepted:
May 4,
2010
Received:
February 8,
2010
Identification
Copyright
© 2010 Journal of Pediatric Urology Company. Published by Elsevier Inc. All rights reserved.
