Laparoscopic Nephroureterectomy for Adult Incontinence Caused by Functioning Ectopic Pelvic Kidney Draining into Vagina

Challacombe, Benjamin; Kelleher, Con; Sami, T.; Scott, Helena; Chandra, Ashish; O’Brien, Tim

doi:10.1089/0892779041271508

Cited by 8 publications

(3 citation statements)

References 2 publications

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“…Laparoscopic surgical approaches have previously been described and developed for the treatment of duplex kidney systems and ectopic ureters 1 2 4. We demonstrated that robotic surgery can be used safely and effectively in the hands of experienced robotic surgeons for management of such cases.…”

Section: Discussionmentioning

confidence: 86%

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Robotic partial nephrectomy for duplex kidney with ectopic ureter draining in the vagina in an adult patient with urinary incontinence

Mahmood¹,

Hadjipavlou

Das

et al. 2017

BMJ Case Reports

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A duplex kidney system with an ectopic ureter draining into the vagina is a congenital malformation that typically presents as refractory urinary incontinence. Diagnosis is often difficult to establish and delayed due to a low incidence. We present the case of a patient aged 26 years with a life-long history of persistent urinary incontinence. Initial presentation was at childhood; however, the diagnosis went undetermined for 22 years. CT urography revealed a duplex kidney with an atrophic upper pole associated with an ectopic ureter that drained into the vaginal vault. This is the first description of such a case being managed successfully via a robot-assisted partial nephrectomy approach. Ectopic ureteral duplication should be considered in the differential diagnosis for young women with refractory urinary incontinence. Robotic partial nephrectomy is a safe and effective technique to manage such cases.

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Section: Discussionmentioning

confidence: 86%

“…This arrangement has previously been identified as an explanation for continuous urinary incontinence 2 4. In addition, due to its relative rarity, it is a diagnosis which is frequently overlooked by many clinicians 1…”

Section: Discussionmentioning

confidence: 92%

Robotic partial nephrectomy for duplex kidney with ectopic ureter draining in the vagina in an adult patient with urinary incontinence

Mahmood¹,

Hadjipavlou

Das

et al. 2017

BMJ Case Reports

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“…The patient resumed normal daily activities within 2 weeks of surgery. Challacombe and colleagues 14 reported a case of a 29-year-old incontinent woman who underwent laparoscopic nephroureterectomy for a functioning dysplastic ectopic pelvic kidney with a tortuous dilated ureter draining into the vagina. The patient was rendered continent following the procedure.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic removal of a pelvic cyst associated with obstructedmegaureter and dysplastic renal remnant

Pianezza

Estey

2013

CUAJ

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We report a case of a 41-year-old man with a solitary functioning left kidney and history of chronic pelvic discomfort associated with lower urinary tract symptoms. Imaging revealed a large cystic structure in the pelvis attached to a dilated tortuous ureter on the right with congenital absence of the right kidney. The patient underwent laparoscopic removal of the pelvic cyst and dilated right ureter. Pathological assessment revealed mesonephric remnants representing dysplastic renal tissue attached to a dilated and obstructed megaureter, extending into the bladder wall and forming a large pelvic cyst. The patient's symptoms resolved. A laparoscopic approach represents an excellent surgical option for pelvic pathology. RésuméNous décrivons le cas d'un homme de 41 ans porteur d'un seul rein fonctionnel (gauche) et ayant des antécédents de douleurs pelviennes chroniques liées à des symptômes affectant les voies urinaires inférieures. Les épreuves d'imagerie ont révélé une masse kystique volumineuse au niveau du pelvis, une dilatation et une sinuosité urétérales du côté droit et l'absence congénitale de rein droit. Le patient a subi une ablation par laparoscopie du kyste pelvien et de la section dilatée de l'uretère droit. L'évaluation pathologique a révélé des vestiges mésonéphriques constitués de tissu rénal dysplasique lié à un méga-uretère obstrué avec dilatation kystique se prolongeant dans la paroi vésicale et formant ainsi un kyste pelvien volumineux. Les symptômes du patient ont disparu. Une approche laparoscopique représente une excellente option chirurgicale en présence de pathologie pelvienne.alterations in a genetic pathway important for nephron or collecting duct formation lead to abnormal development, occasionally with cyst formation, and the second caused by obstruction.1-3 Obstructive conditions associated with renal dysplasia include primary obstructive megaureter and ureteropelvic junction obstruction. 4,5Laparoscopic nephrectomy and nephroureterectomy for dysplastic kidneys are now becoming widely accepted procedures for the pediatric population, 6-9 but are uncommon for the adult population. We report a case involving the laparoscopic removal of a dysplastic kidney with a primary obstructed megaureter associated with a symptomatic large pelvic cyst. Case reportA 41-year-old man presented with a several-year history of chronic, nonspecific symptoms in his pelvis and lower back. The patient also complained of urinary frequency (15-20 times/d) and urgency. The symptoms had been progressing during the previous 2 years. There was no history of urinary tract infections or prostatitis. The patient did not respond to α-blockers, antibiotics or antispasmodic therapy. The patient was known to have a solitary left kidney. Physical examination revealed a benign abdomen with a normal penis and normal testicles and spermatic cords. Digital rectal examination revealed an increased sphincter tone and empty rectum. The prostate was mildly enlarged with a distinct area of induration noted on the right pos...

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Embryology and Development of Congenital Anomalies of the Pelvis and Female Organs

Naidoo

Mbajiorgu

Adam

2023

Female Genitourinary and Pelvic Floor Reconstruction

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Laparoscopic Nephroureterectomy for Adult Incontinence Caused by Functioning Ectopic Pelvic Kidney Draining into Vagina

Cited by 8 publications

References 2 publications

Robotic partial nephrectomy for duplex kidney with ectopic ureter draining in the vagina in an adult patient with urinary incontinence

Robotic partial nephrectomy for duplex kidney with ectopic ureter draining in the vagina in an adult patient with urinary incontinence

Laparoscopic removal of a pelvic cyst associated with obstructedmegaureter and dysplastic renal remnant

Embryology and Development of Congenital Anomalies of the Pelvis and Female Organs

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