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. 2025 May;19(3):168-172.
doi: 10.1097/CU9.0000000000000238. Epub 2024 Mar 12.

Modified percutaneous nephropexy for nephroptosis: Technical description and short-term results

Honglei Liu  1 , Wenzhi Gao  2 , Zheng Zhang  1 , Kunlin Yang  3 , Chang Meng  3 , Bing Wang  1 , Yangjun Han  1 , Mingxin Diao  1 , Chao Zuo  1 , Minghua Zhang  1 , Yingzhi Diao  1 , Zhihua Li  3 , Xinfei Li  3 , Gang Wang  3 , Chunji Wang  1 , Zihui Gao  1 , Yaming Gu  1 , Xuesong Li  1   3
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Modified percutaneous nephropexy for nephroptosis: Technical description and short-term results

Honglei Liu et al. Curr Urol. 2025 May.

Abstract

Objectives: Percutaneous nephropexy (PCN) has been demonstrated as a feasible method for treating nephroptosis. This study describes an improved technique for PCN that better addresses the issue of nephroptosis.

Materials and methods: We reviewed 4 patients who underwent the improved PCN procedure between January 2021 and January 2023. These patients were diagnosed with nephroptosis, with 1 case having both a narrow ureteropelvic junction and nephroptosis due to a kidney stone, and 3 cases having simple nephroptosis. Patient characteristics, perioperative data, and follow-up results were collected. Surgical success was determined by symptom relief (subjective success) and the absence of kidney descent by intravenous pyelography (objective success).

Results: Preoperative computed tomography urography showed that all patients had hydronephrosis, with severe hydronephrosis in 75% (3/4) and moderate hydronephrosis in 25% (1/4) of cases. The mean operative time was 63.8 minutes (range, 45-95 minutes), and the mean blood loss was 5 mL (range, 5-50 mL). The mean length of hospital stay was 4.5 days (range, 3-6 days). The mean time to removal of the nephrostomy tube was 2 months (range, 1-4 months). No serious complications (Clavien-Dindo grade ≥3) occurred during or after the procedure. The mean postoperative serum creatinine level was 54.75 μmol/L (range, 43-65 μmol/L). The mean follow-up time was 6.25 months (range, 4-8 months). The objective and subjective success rates were both 100%.

Conclusions: The improved PCN procedure that was used in this study is feasible and provides a good option for treating nephroptosis.

Keywords: Hydronephrosis; Intravenous pyelography; Nephropexy; Nephroptosis.

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Conflict of interest statement

XL is an associate editor of Current Urology. This article was accepted after a normal external review. No conflict of interest has been declared by the other authors.

Figures

Figure 1
Figure 1
Preoperative supine (A) and standing (B) intravenous pyelography. Postoperative supine (C) and standing (D) intravenous pyelography.
Figure 2
Figure 2
The actual surgical steps. (A) Mark the 12-rib position. (B) Preoperative position. (C) Ultrasound localization. (D) Dilator dilatation step by step. (E) Nephroscopic exploration. (F) Placement of the fistula.
See this image and copyright information in PMC

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