Supernumerary kidney laparoscopically treated

Abstract

Congenital anomalies of the kidney and urinary tract are part of a family of diseases with different anatomical origins. Duplicated collecting systems can be defined as a renal unit containing 2 pyelocalyceal systems associated with a single ureter or with double ureters. The supernumerary kidney is a definitive accessory organ with its own collecting system, blood supply, and distinct encapsulated parenchima. The true incidence of supernumerary kidney remains unknown, but most cases are in males, are unilateral and on the left side. We present a case of an adult woman with a hypoplastic supernumerary kidney with a complete ureteral duplication and an ectopic junction. The case has been laparoscopically treated. We demonstrate that a laparoscopic nephro-ureterectomy is feasible and that the management of the complication (urinoma and fistula) can be managed conservatively.

Fig. 1

(A) Diagnostic retrograd pyelography that revealed a duplicated right ureter with one dilated ectopic ureteric orifice into the urethra. (B) Preoperative magnetic resonace that confirmed a complete duplicated system with a nonfunctioning upper pole renal unit related to an ectopic ureteric orifice into the pre-sphincteric urethra. (C) Atrophic kidney with his ureter at surgery.

Fig. 2

(A) Postoperative computed tomography scan: urinoma after laparoscopic surgical treatment. (B) Postoperative magnetic resonance (MR): right kidney upper pole with evidence of urinary fistula. (C) Postoperative MR that showed an upper pole capsulated cavity of the right kidney with no further evidence of fistula or urinoma.