Successful Retrograde Intrarenal Surgery for a Large Kidney Stone in a Pelvic Ectopic Kidney: A Case Report and Review of Literature

Abstract

An ectopic kidney is a condition in which one or both kidneys are located outside of their normal anatomical position, typically lower than  usual, and are prone to stone disease. In the past, most patients required open surgical treatment, but nowadays, laparoscopy-assisted percutaneous nephrolithotomy and multisession retrograde intrarenal surgery (RIRS) facilitate minimally invasive approaches. A 42-year- old male presented to the urology clinic with complaints of intermittent lower midabdominal pain near the suprapubic area for a year. A  computed tomography scan evaluation of the abdomen without contrast was then performed, showing incomplete staghorn with multiple calyceal stones in the ectopic kidney, with the largest stone measuring 2 × 1.2 cm and mild hydronephrosis. A single-session RIRS  was performed which successfully disintegrated the stone. This pelvic kidney, although situated within the retroperitoneum, has the  bowels positioned between the front wall of the abdomen and the kidney. The successful navigation of the flexible ureteroscope  through the deformed urinary tract made RIRS applicable in the presence of a urinary tract deformity. This case was managed with RIRS, which offers advantages in visualization and is considered a safer option compared to other methods.