Successful Endoscopic Management for the Adult Patient with Non-Functioning Atrophic Kidney Caused by Obstructed Ureteral Stone: Two-Step Treatment Strategy

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

^*Correspondance to: Takaaki Inoue 

 PDF  Full Text DOI: 10.25107/2474-1647.2893

Abstract

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.

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Cite the article

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..