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Year : 2013  |  Volume : 10  |  Issue : 3  |  Page : 285-288

Laparascopic-assisted nephroureterectomy for shaped urolithiasis and xanthogranulomatous pyelonephritis: Case report and review of literature

1 Department of Clinical and Surgical Medicine, Paediatric Surgery Unit, University of Foggia, Foggia, Italy
2 Biomedicine of Evolutive Age, Paediatric Nephrology Unit, University of Bari, Bari, Italy

Correspondence Address:
Valentina Pastore
Paediatric Surgery Unit, University of Foggia, Viale Pinto 1-71122, Foggia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0189-6725.120890

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We report a case of xanthogranulomatous pyelonephritis (XGP) complicated by shaped urolithiasis, severe hydroureteronephrosis and kidney exclusion treated by laparoscopic-assisted nephroureterectomy. A 9 year-old boy was referred to us for recurrent episodes of urinary tract infection, abdominal pain and severe hydronephrosis. Abdominal CT and a Tc-99m MAG3 scan showed a non-functioning obstructed kidney with shaped urolithiasis of the distal ureter. XGP was suspected, and nephroureterectomy was performed by laparoscopic distal ureterectomy and open extraperitoneal nephrectomy. This technique avoided the need for a more extended nephrectomy incision or even a second iliac incision. It also ensured complete excision of the distal ureter with minimal risk of developing the ureteral stump syndrome, which sometimes follows nephroureterectomy. We believe that laparoscopic-assisted nephroureterectomy may be a suitable technique in those cases of difficult nephrectomy where a ureteral stump syndrome is likely to develop.

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