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World Journal of Urology
Published in: World Journal of Urology 5/2020

Open Access 01-05-2020 | Urolithiasis | Invited Review

Outcomes of ureteroscopy for stone disease in anomalous kidneys: a systematic review

Authors: Lisa Lavan, Thomas Herrmann, Christopher Netsch, Benedikt Becker, Bhaskar K. Somani

Published in: World Journal of Urology | Issue 5/2020

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Abstract

Introduction

Treatment of stone disease in anomalous kidneys can be challenging. As ureteroscopy (URS) has advanced, the number of studies reporting on outcomes of URS for stone disease in anomalous kidneys has increased. Our objective was to perform a systematic review of the literature to evaluate the outcomes of URS for stone disease in this group of patients.

Methods

A Cochrane style review was performed in accordance with the PRISMA guidelines using Medline, EMBASE, CINAHL, Cochrane Library, Scopus and individual urologic journals for all English language articles between inception and June 2018.

Results

Fourteen papers (413 patients) with a mean age of 43 years and a male to female ratio of 285:128 were included. The underlying renal anomaly was horseshoe kidney (n = 204), ectopic kidney (n = 117), malrotation (n = 86), cross fused ectopia (n = 2) and others (n = 2). With a mean stone size of 16 mm (range 2–35 mm), the majority of stones were in the lower pole (n = 143, 34.6%) or renal pelvis (n = 128, 31.0%), with 18.9% (n = 78) having stones in multiple locations. Treatment modality included the use of flexible ureteroscope in 90% of patients and ureteral access sheath used in 11 studies. With a mean operative time of 61.3 min (range 14–185 min), the initial and final SFR was 76.6% (n = 322) and 82.3% (n = 340), respectively. The overall complication rate was 17.2% (n = 71), of which 14.8% were Clavien I/II and the remaining 2.4% were Clavien ≥ III complications.

Conclusion

Although ureteroscopy in patients with anomalous kidneys can be technically challenging, advancements in endourological techniques have made it a safe and effective procedure. In these patients the stone-free rates are good with a low risk of major complications.
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Metadata
Title
Outcomes of ureteroscopy for stone disease in anomalous kidneys: a systematic review
Authors
Lisa Lavan
Thomas Herrmann
Christopher Netsch
Benedikt Becker
Bhaskar K. Somani
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Keyword
Urolithiasis
Published in
World Journal of Urology / Issue 5/2020
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-019-02810-x

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