Takaaki Inoue1,2*, Fukashi Yamamichi1, Masaichiro Fujita1, Hideto Ueki1 and Masato Fujisawa2
1Department of Urology, Hara Genitourinary Hospital, Japan
2Department of Urology, Kobe University, Japan
Background: Most patients with non-functioning atrophic kidney caused by obstructed ureteral stone often are performed simple nephrectomy to prevent infectious status. However, kidney function might still remain even if there is non-function kidney in pre-operative imaging study. We experienced a successful endoscopic management for non-functioning atrophic kidney caused by obstructed kidney-ureteral stone. Case Report: We had an experience with multiple large kidney-impacted ureteral stones in nonfunctioning atrophic left kidney examined by pre-operative 99mTc-MAG3 renography. In first step, we determined to place the percutaneous nephrostomy in left kidney to find real remained kidney function. Urine through nephrostomy was produced around 750ml a day. In second step, we performed minimally invasive endoscopic combined with intrarenal surgery to remove all large stones under the Bart’s modified Valdivia position. The procedures for kidney-impacted ureteral stones succeeded. Finally, serum eGFR had improved in comparison to pre-operative level. Conclusion: We believe there is still remained kidney function even if being diagnosed nonfunctioning kidney in pre-operative 99mTc-MAG3 renography. Endourological procedures might be quite available to preserve the kidney function.
Inoue T, Yamamichi F, Fujita M, Ueki H, Fujisawa M. Successful Endoscopic Management for the Adult Patient with Non-Functioning Atrophic Kidney Caused by Obstructed Ureteral Stone: Two-Step Treatment Strategy. Clin Surg. 2020; 5: 2893..