Pelvic Kidney: Associated Diseases and Treatment

Abstract

The incidence of pelvic kidney has been approximated at between 1 in 2200 and 1 in 3000. The ectopic kidney is thought to be no more susceptible to disease than the normally positioned kidney, except for the development of calculi and hydronephrosis. Because of the greater risk of injuring aberrant vessels or overlying abdominal viscera and nerves, the pelvic kidney presents special treatment challenges. Alternative approaches to treating nephrolithiasis may yield better outcomes. The tortuous ureter often associated with a pelvic kidney hinders deflection of the flexible ureteroscope, potentially limiting access. Laparoscopy-guided intervention permits visual exposure of the kidney, enhancing safe puncture and tract placement integral to percutaneous nephrolithotomy. Laparoscopy-assisted anterior retrograde percutaneous nephroscopy involves percutaneous access using a Hunter-Hawkins retrograde nephrostomy needle with adjunctive laparoscopy to permit viewing and manipulation of overlying bowel. Ureteropelvic junction (UPJ) obstruction has been reported to occur in 22% to 37% of ectopic kidneys. Endoscopic incision presents difficulties beyond those of anatomically normal kidneys. The laparoscopic approach provides good surgical exposure, and operative times are comparable to those of laparoscopic pyeloplasty in anatomically normal kidneys. To date, only a handful of cases of malignancy in a pelvic kidney have been described. Like a nonfunctioning anatomically normal kidney, a nonfunctional pelvic kidney may require primary removal. There are a few reports of laparoscopic pelvic nephrectomy. Additional studies are needed to compare the various treatments for disease of the pelvic kidney in order to decide which options have the most beneficial outcomes.

Deep renal ectopia causing sciatic mononeuropathy

“…The incidence of renal ectopia is reported between 1 in 2,200 and 1 in 3,000 [1]. However, a study screening 132,686 school children (6 to 15 years of age) found a lower incidence of 1 in 5000 children [4].…”

“…The incidence of a pelvic kidney is estimated between 1 in 2,200 and 1 in 3,000 [1]. Given the rarity of a pelvic kidney, it is often an incidental finding on imaging studies or an unsuspected finding in patients presenting with vague or atypical symptoms.…”

Ectopic Pelvic Kidney Mimicking Adnexal Mass: A Case Report

“…Increased incidence of renal cell tumors in pelvic kidneys should be taken into consideration (14) . For that reason nephrectomy has been recommended for pelvic and nonfunctional kidneys (15) .…”

Kidney, Urinary Bladder, and Ureter

“…During ascent, the kidneys proceed through a bifurcation formed by the umbilical arteries. If one of the kidneys fails to pass this point, it remains within the pelvis next to the common iliac artery (Sadler 1990;Cocheteux et al 2001;Cinman et al 2007). …”