A Case of Hydronephrosis Associated With Horseshoe Kidney Successfully Treated by Retroperitoneoscopic Isthmusectomy Without Pyeloplasty.

IF 0.5 Q4 Medicine

IJU Case Reports Pub Date : 2026-09-20 eCollection Date: 2026-09-01 DOI:10.1002/iju5.70263

Rento Ito, Renpei Kato, Ayato Ito, Ei Shiomi, Masakazu Abe, Daiki Ikarashi, Shigekatsu Maekawa, Mitsugu Kanehira, Wataru Obara

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Abstract

Pyeloplasty is generally considered the standard treatment for congenital hydronephrosis associated with horseshoe kidney. We report a case successfully managed mainly by retroperitoneoscopic isthmusectomy without pyeloplasty.

Case presentation: A 23-year-old man presented with left flank-to-back pain. CT revealed horseshoe kidney and left hydronephrosis. The left ureteropelvic junction was considered compressed by renal malrotation, causing obstruction. Retroperitoneoscopic isthmusectomy was performed using an articulating endoscopic linear stapler, resulting in hydronephrosis improvement.

Conclusion: In selected patients with horseshoe kidney in whom congenital hydronephrosis is primarily caused by renal malrotation associated with isthmic fusion and aberrant vessel involvement appears limited, treatment mainly consisting of retroperitoneoscopic isthmusectomy using an articulating stapling device may be effective.

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后腹膜镜峡部切除无肾盂成形术成功治疗马蹄肾伴肾积水1例。

肾盂成形术通常被认为是先天性马蹄肾积水的标准治疗方法。我们报告一个病例成功地处理主要是腹膜后镜峡肌切除术没有肾盂成形术。病例介绍：一名23岁男性，表现为左腰到背部疼痛。CT示马蹄肾及左侧肾积水。左侧肾盂输尿管连接处因肾脏旋转不良而受压，造成梗阻。使用关节内窥镜线性吻合器进行后腹膜镜峡部切除术，导致肾积水改善。结论：在部分马蹄肾患者中，先天性肾积水主要由肾脏旋转不良合并峡部融合和异常血管受损伤引起，治疗主要包括使用关节吻合器的后腹膜镜峡部切除术可能有效。

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