Surgical Treatment of Renal Fusion Anomalies

Overview

Objective:
To present problems and outcome of the treatment of renal fusion anomalies in children. Between January 1994 and June 2006 there were 8 children with horseshoe kidney and one with sigmoid kidney treated at our institution. One child required reimplantation of both ureters for combination of obstruction and reflux, one child needed resection of the lower pole of sigmoid kidney for cystic degeneration, one child resection of part of the right moiety of horseshoe kidney for Wilms’ tumour, one child resection of the cranial part of the right duplex moiety for non-functioning of the upper pole. The remaining five children underwent dismembering pyeloplasty, four of them with transposition of the renal anomalous vessels for ureteropelvic junction obstruction.

Results:
One child was inserted a double “J” stent in her ureter and renal pelvis for malfunction of the reconstructed PU junction. One child experienced progressive worsening of the function of the remaining lower pole of the right part of horseshoe kidney after heminephrectomy. All other children are doing well inclusive patient with Wilms’ tumour.

Conclusion:
Renal fusion anomalies are often associated with other pathology. Simple fusion anomaly without other pathology does not require specific treatment. In our cohort a resection of the isthmus of the horseshoe kidney was never necessary. The patients require appropriate treatment and close follow-up.

Key words:
horseshoe kidney, hydronephrosis, Wilms’ tumour, renal fusion anomaly, operation