Approach to kidney stones associated with ureteropelvic junction obstruction during laparoscopic pyeloplasty.
BACKGROUND
We have performed laparoscopic pyeloplasty (LP) in our department since 2004. Our goal is to describe, step by step, the approach of kidney stones during transperitoneal laparoscopic pyeloplasty and the outcomes after the procedure.


METHODS
Twelve patients with kidney stones treated by transperitoneal laparoscopic pyeloplasty were found. The hospital records with clinical features, supplementary tests, and imaging studies were reviewed for demographic, procedural, and efficacy data.


RESULTS
Kidney stones were found in 12 of 62 patients (19%) who had undergone transperitoneal laparoscopic pyeloplasty. Eight cases were treated using a flexible cystoscope and a nitinol N-Circle basket; in the remaining four cases the stones were extracted using laparoscopic grasping instruments. We want to emphasize a case of horseshoe kidney associated with ureteropelvic junction (UPJ) obstruction and a kidney stone in which the procedure was performed successfully.


CONCLUSIONS
Laparoscopic pyeloplasty has now emerged as a standard approach to UPJ obstruction. Associated renal abnormalities or kidney stones add complexity to the procedure, however, as shown in our results, centers with experience in the laparoscopic approach of reconstructive urology make this technique feasible.
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Juan Gómez
JG
Rivas
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Sergio
S
Alonso Y Gregorio
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Leslie Cuello
LC
Sánchez
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Cristina de Castro
Cde C
Guerin
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Angel Tabernero
AT
Gómez
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Luis Hidalgo
LH
Togores
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Jesús Javier de la Peña
JJ
Barthel
horseshoe kidney; kidney stones; laparoscopic pyeloplasty; reconstructive urology