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Laparoscopic pyeloplasty in a solitary kidney

Nature Clinical Practice Urology volume 4, pages 625–629 (2007)Cite this article

Abstract

Background A 40-year-old male presented with right-sided abdominal pain and no lower urinary tract symptoms. Examination was unremarkable, apart from mild right renal angle tenderness.

Investigations Renal function, full blood count and C-reactive protein levels were all normal. Ultrasound of renal tract, abdominal computed tomography (CT) and 99mTc-mercaptoacetyltriglycine (MAG3) renogram confirmed ureteropelvic junction obstruction.

Diagnosis The ureteropelvic junction obstruction of the right kidney was identified, with a crossing lower pole renal vessel as the possible cause. An absent left kidney was also noted.

Management Laparoscopic transperitoneal dismembered Anderson–Hynes pyeloplasty was performed, with posterior transposition of the crossing lower pole vessel.

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Figure 1: A CT image showing the ureteropelvic junction with the lower pole-crossing vessel on the right side.
Figure 2: 99mTc-MAG3 study shows a non-functioning left kidney.
Figure 3: Laparoscopic view of the newly constructed ureteropelvic junction (Anderson–Hynes pyeloplasty) with the posteriorly transposed crossing vessel.
Figure 4: Completion of the pyeloplasty with the transposed lower pole vessel (inferiorly) and the liver and perirenal fat (superiorly).
Figure 5: The 99mTc-MAG3 study shows normal tracer uptake and excretion consistent with normal function.

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Acknowledgements

The authors would like to thank PM Ball, Senior Medical Artist, University of Cambridge for drawing Figure 4, and Dr K Balan, Consultant in Nuclear Medicine Department, Addenbrookes Hospital for his assistance with Figures 2 and 5.

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Authors and Affiliations

  1. and NC Shah is a Consultant Urologist at the Urology Department, N Zafar is a Clinical Fellow, J Leyland is a Senior Fellow, Addenbrookes Hospital, Cambridge, UK.,

    Nauman Zafar, John Leyland & Nimish C Shah

Authors
  1. Nauman Zafar
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  2. John Leyland
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  3. Nimish C Shah
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Corresponding author

Correspondence to Nimish C Shah.

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The authors declare no competing financial interests.

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Zafar, N., Leyland, J. & Shah, N. Laparoscopic pyeloplasty in a solitary kidney. Nat Rev Urol 4, 625–629 (2007). https://doi.org/10.1038/ncpuro0961

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