Early experience of intraureteric capsaicin infusion in loin‐pain haematuria syndrome

Loin Pain and Haematuria Syndrome (LPHS) Linked to Symptomatic Nephroptosis (SN) and Revealing Pedicle Stretch Causing Neuro-Ischaemia Using the New IVU 7 Sign

“…Although, these causes, and rarely UTI, may contribute to the establishment of pyelocalyctaisis, [13][14][15] the lesion seems primarily ischemic [10][11][12]. The link of SN with LPHS was illusive and overlooked, particularly when the ischemic complications of auto-nephropexy, auto-nephrectomy and sympathetic nephroplegia involving the normal contra-lateral kidney occurred insidiously over many years [1].…”

“…The demonstrable pathology on upright IVU, [2,3,[9][10][11][12][13][14][15][16] arteriography [11,12] and IR [2,13] are well documented on SN that was discarded long ago [4]. Upright imaging is currently undone and has not been reported previously in LPHS.…”

“…Many complex ramifying management problems of SN and LPHS are well known, but have no solutions. Some of the problems were communicated [9,10] and the illusive overlooked link of SN with LPHS was pointed out recently [1,2]. Nephroptosis is differentially diagnosed from ectopic Kidney by blood supply and mobility.…”

Intra‐ureteric capsaicin in loin pain haematuria syndrome: efficacy and complications

“…Recent reports suggest another cause of LPHS, i.e. symptomatic nephroptosis (SN) [2–4], which may help to direct the search for a successful therapy, saving the efforts, expense and disappointments of researching ineffective methods.…”

“…The results confirmed that all patients had SN, on repeated IVU with the patient standing. The natural history of the features of SN and the causes of its complications were reported for 36 (19%) patients with LPHS and four (2%) with renal atrophy [2,3]. Renal pain was heterogeneous, difficult to resolve and elusive both for stages of reversible SN and irreversible LPHS.…”