Pathological Pelvic Kidneys

Abstract

Aims: To analyse the surgical management of pathological pelvic kidneys (PPK).

Patients and Method: This was a monocentric descriptive retrospective study carried out between 1 January, 2016 and 31 December, 2019. We collected the files of patients with PPK surgery. The anatomaclinical, therapeutic and evolutionary epidemiological aspects were analysed.

Results: We identified 17 patients over a period of 4 years, i.e. a frequency of 4.25 cases per year. The mean age of the patients was 33.35 ± 18.03 years [08 years – 72 years]. The sex ratio was 1.42. Abdominal-pelvic pain was reported by all patients and there was a pelvic mass in 2 patients. Uro-CT had made it possible to make the diagnosis of pelvic kidney and to identify the type of complication in all our patients. In 7 patients, there was malrotation of the kidney. Renal ectopia was simple in all our patients and involved the left kidney in 58% of cases. The pyelo-ureteral junction syndrome was the main objectified complication (n = 8, i.e. 47%) followed by pyelic lithiasis (n = 5, i.e. 29.4%). All patients had open surgery; two initially had a JJ probe rise. Pyeloplasty was the most performed intervention (n = 8, i.e. 47%). It was associated in all cases with drainage by a double J catheter. Total nephrectomy was identified in 4 patients. The average hospital stay was 6 days. The evolution was favorable in all our patients.

Conclusion: Our series is characterised by a diagnostic delay and a considerable rate of radical surgery. We insist on the need for antenatal diagnosis and regular monitoring of PPK.