Urolithiasis in horseshoe kidneys: therapeutic management.
OBJECTIVE
We sought to compare the results of different therapeutic strategies in patients with horseshoe kidneys and urolithiasis.


METHODS
The records of 47 patients (28 male, 19 female; mean age, 42 years) with horseshoe kidney treated for urolithiasis from 1983 to 1994 were reviewed retrospectively and follow-up studies of 38 of 47 patients were obtained after 7 to 122 months (mean, 79).


RESULTS
Open surgery was performed in 6 patients with ureteropelvic junction obstruction; 1 required nephrectomy of a nonfunctioning right kidney and the other 5 are stone free. Percutaneous nephrolithotomy (PNL) was performed in 4 patients with normal drainage and a moderate to large stone burden; 3 became stone free and the other required extracorporeal shock-wave lithotripsy (ESWL) secondarily. In the remaining 37 patients with normal drainage and a small to moderate stone burden, ESWL achieved a 100% disintegration rate and a 76% stone-free rate.


CONCLUSIONS
The presence of anatomic obstruction will necessitate open surgery for urolithiasis in patients with horseshoe kidney; however, in patients with normal urinary drainage PNL or ESWL can be considered, either singly or as a part of combination therapy. When management is tailored to the individual patient's needs, results of stone treatment can be equivalent to those in normal kidneys.
Lampel
A
A
Department of Urology, University of Witten/Herdecke, Medical School, Klinikum Barmen, Wuppertal, Germany.
Hohenfellner
M
M
Schultz-Lampel
D
D
Lazica
M
M
Bohnen
K
K
Thürof
J W
JW
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009403:Nephrostomy, Percutaneous; D011859:Radiography; D012189:Retrospective Studies; D014463:Ultrasonography; D014545:Urinary Calculi / Q000737:chemistry / Q000175:diagnosis / Q000628:therapy*