Ovulatory dysuria: a bizarre presentation of crossed non-fused ectopic kidney with extra renal pelvis

Abstract

Ectopic kidneys are a unique form of congenital anomaly that in most cases remain asymptomatic. However, depending on the location and the associated anatomical variations, they can mimic certain more common conditions, posing a challenge in differential diagnosis. They could cause secondary symptoms by virtue of their location or could falsely mimic a primary urologic problem when the etiology might be from a closely opposed adjacent structure. We present a unique case of ovulatory dysuria in a young female with a crossed non-fused ectopic kidney. The patient's symptoms were recurrent and correlated with the ovulatory phase of the menstrual cycle. Work-up revealed the right ovary to be in close proximity to the pelvis of the ectopic kidney. Salpingo-oophrectomy was followed by complete resolution of the patient's symptoms. The clinical manifestations, work-up, and management of symptomatic ectopic kidneys are briefly discussed in our article. Symptoms are usually attributed only by systematically excluding other causes. Surgical intervention is a last resort option only after thorough work-up with appropriate imaging studies.

A Large Calculus in Crossed Renal Ectopia without Fusion: A Case Report

“…A heart-shaped stone. Most cases of crossed renal ectopia are asymptomatic and noted incidentally during autopsy, screening tests, or during investigation for unrelated causes [1,6]. Urinary tract disease such as vesicoureteral reflux, urinary tract infections, ureteroceles, renal calculi, and renovascular hypertension can coexist with ectopic kidneys, which are likely to be complicated by ureteropelvic junction obstruction because of their frequent abnormal shape, malrotation, and aberrant vasculature [9].…”

“…Only 10% are of the nonfused variety. Most cases remain undiagnosed because they remain asymptomatic [1]. We report a case of crossed left-toright renal ectopia with stones and successful management.…”

Crossed Renal Ectopia without Fusion—An Unusual Cause of Acute Abdominal Pain: A Case Report

“…Most cases of crossed renal ectopia are asymptomatic and are noted incidentally during autopsy, screening tests, or during investigation for unrelated causes [1, 3]. Of these, the commonest form seen is the fusion variety, accounting for 90% of cases [4], having reported incidence of 1 in 7,500 autopsies.…”

“…The presentation of acute abdominal pain was thought to be due to abdominal aortic aneurysm, even though there was no prior history. This is because renal ectopias are usually asymptomatic [1]. It was after exclusion of other pathologies that the cause of abdominal pain was attributed to renal ectopia.…”

“…Most cases remain undiagnosed because they remain asymptomatic [1]. From 20 to 30% of cases are incidentally diagnosed [2].…”