Endoscopic Management of Urolithiasis in the Horseshoe Kidney

Andrew T. Blackburne, Marcelino E. Rivera, Matthew T. Gettman, David E. Patterson, Amy Krambeck

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective To assess the endourologic outcomes of patients diagnosed with a horseshoe kidney (HK) and symptomatic urolithiasis. Methods A retrospective review was performed of patients diagnosed with an HK who underwent endoscopic management from 2002 to present. Results We identified 45 patients with 64 stone-bearing moieties who underwent 56 procedures, of which 31 (69%) were male. Mean age was 49.4 years (23-78) and mean stone size was 1.6 cm (0.2-5.7). Of the 64 moieties, 37 (58%) underwent percutaneous nephrolithotomy (PCNL), 25 (39%) underwent ureteroscopy (URS), and 2 (3%) underwent extracorporal shockwave lithotripsy (SWL). More than one access was utilized in 2 (5.7%) moieties undergoing PCNL. Additional procedures were required in 10 (28.5%) PCNL patients, of which 7 were URS, 2 were secondary PCNL, and 1 sandwich therapy with SWL and PCNL. Stone-free rate by moiety was 81.1% for PCNL, 84% for URS, and 50% for SWL. Postoperative complications occurred in 3 patients in the PCNL group, including readmission for pain and complicated urinary tract infection. With a mean follow-up of 20.5 months (range 0-118 months), stone recurrence was noted in 7 (16%) patients with a total of 11 events. Calcium oxalate was the most common stone type and 20/24 (83%) of patients with metabolic evaluations were found to have at least one abnormality. Conclusion After careful consideration of the anatomy, individuals with HK and symptomatic urolithiasis can be managed safely by a variety of endoscopic approaches with excellent outcomes; however, secondary procedures and recurrence are common.

Original languageEnglish (US)
Pages (from-to)45-49
Number of pages5
JournalUrology
Volume90
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

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Percutaneous Nephrostomy
Urolithiasis
Ureteroscopy
Lithotripsy
Recurrence
Calcium Oxalate
Fused Kidney
Urinary Tract Infections
Anatomy
Pain

ASJC Scopus subject areas

  • Medicine(all)
  • Urology

Cite this

Blackburne, A. T., Rivera, M. E., Gettman, M. T., Patterson, D. E., & Krambeck, A. (2016). Endoscopic Management of Urolithiasis in the Horseshoe Kidney. Urology, 90, 45-49. https://doi.org/10.1016/j.urology.2015.12.042

Endoscopic Management of Urolithiasis in the Horseshoe Kidney. / Blackburne, Andrew T.; Rivera, Marcelino E.; Gettman, Matthew T.; Patterson, David E.; Krambeck, Amy.

In: Urology, Vol. 90, 01.04.2016, p. 45-49.

Research output: Contribution to journalArticle

Blackburne, AT, Rivera, ME, Gettman, MT, Patterson, DE & Krambeck, A 2016, 'Endoscopic Management of Urolithiasis in the Horseshoe Kidney', Urology, vol. 90, pp. 45-49. https://doi.org/10.1016/j.urology.2015.12.042
Blackburne, Andrew T. ; Rivera, Marcelino E. ; Gettman, Matthew T. ; Patterson, David E. ; Krambeck, Amy. / Endoscopic Management of Urolithiasis in the Horseshoe Kidney. In: Urology. 2016 ; Vol. 90. pp. 45-49.
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abstract = "Objective To assess the endourologic outcomes of patients diagnosed with a horseshoe kidney (HK) and symptomatic urolithiasis. Methods A retrospective review was performed of patients diagnosed with an HK who underwent endoscopic management from 2002 to present. Results We identified 45 patients with 64 stone-bearing moieties who underwent 56 procedures, of which 31 (69{\%}) were male. Mean age was 49.4 years (23-78) and mean stone size was 1.6 cm (0.2-5.7). Of the 64 moieties, 37 (58{\%}) underwent percutaneous nephrolithotomy (PCNL), 25 (39{\%}) underwent ureteroscopy (URS), and 2 (3{\%}) underwent extracorporal shockwave lithotripsy (SWL). More than one access was utilized in 2 (5.7{\%}) moieties undergoing PCNL. Additional procedures were required in 10 (28.5{\%}) PCNL patients, of which 7 were URS, 2 were secondary PCNL, and 1 sandwich therapy with SWL and PCNL. Stone-free rate by moiety was 81.1{\%} for PCNL, 84{\%} for URS, and 50{\%} for SWL. Postoperative complications occurred in 3 patients in the PCNL group, including readmission for pain and complicated urinary tract infection. With a mean follow-up of 20.5 months (range 0-118 months), stone recurrence was noted in 7 (16{\%}) patients with a total of 11 events. Calcium oxalate was the most common stone type and 20/24 (83{\%}) of patients with metabolic evaluations were found to have at least one abnormality. Conclusion After careful consideration of the anatomy, individuals with HK and symptomatic urolithiasis can be managed safely by a variety of endoscopic approaches with excellent outcomes; however, secondary procedures and recurrence are common.",
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AB - Objective To assess the endourologic outcomes of patients diagnosed with a horseshoe kidney (HK) and symptomatic urolithiasis. Methods A retrospective review was performed of patients diagnosed with an HK who underwent endoscopic management from 2002 to present. Results We identified 45 patients with 64 stone-bearing moieties who underwent 56 procedures, of which 31 (69%) were male. Mean age was 49.4 years (23-78) and mean stone size was 1.6 cm (0.2-5.7). Of the 64 moieties, 37 (58%) underwent percutaneous nephrolithotomy (PCNL), 25 (39%) underwent ureteroscopy (URS), and 2 (3%) underwent extracorporal shockwave lithotripsy (SWL). More than one access was utilized in 2 (5.7%) moieties undergoing PCNL. Additional procedures were required in 10 (28.5%) PCNL patients, of which 7 were URS, 2 were secondary PCNL, and 1 sandwich therapy with SWL and PCNL. Stone-free rate by moiety was 81.1% for PCNL, 84% for URS, and 50% for SWL. Postoperative complications occurred in 3 patients in the PCNL group, including readmission for pain and complicated urinary tract infection. With a mean follow-up of 20.5 months (range 0-118 months), stone recurrence was noted in 7 (16%) patients with a total of 11 events. Calcium oxalate was the most common stone type and 20/24 (83%) of patients with metabolic evaluations were found to have at least one abnormality. Conclusion After careful consideration of the anatomy, individuals with HK and symptomatic urolithiasis can be managed safely by a variety of endoscopic approaches with excellent outcomes; however, secondary procedures and recurrence are common.

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