Ovulatory dysuria: a bizarre presentation of crossed non-fused ectopic kidney with extra renal pelvis.
Ectopic kidneys are a unique form of congenital anomaly that in most cases remain asymptomatic. However, depending on the location and the associated anatomical variations, they can mimic certain more common conditions, posing a challenge in differential diagnosis. They could cause secondary symptoms by virtue of their location or could falsely mimic a primary urologic problem when the etiology might be from a closely opposed adjacent structure. We present a unique case of ovulatory dysuria in a young female with a crossed non-fused ectopic kidney. The patient's symptoms were recurrent and correlated with the ovulatory phase of the menstrual cycle. Work-up revealed the right ovary to be in close proximity to the pelvis of the ectopic kidney. Salpingo-oophrectomy was followed by complete resolution of the patient's symptoms. The clinical manifestations, work-up, and management of symptomatic ectopic kidneys are briefly discussed in our article. Symptoms are usually attributed only by systematically excluding other causes. Surgical intervention is a last resort option only after thorough work-up with appropriate imaging studies.
Gopaldas
Raja R
RR
Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA. doctorgopaldas@yahoo.com
Walden
Thomas B
TB
D000328:Adult; D002828:Choristoma / Q000000981:diagnostic imaging / Q000601:surgery*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007668:Kidney; D007682:Kidney Pelvis / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D010052:Ovariectomy / Q000379:methods; D010060:Ovulation; D014057:Tomography, X-Ray Computed