Lower pole heminephrectomy: Its role in treating nonfunctioning lower pole segments

Y. Mor, P. D. Mouriquand, G. F. Quimby, P. F. Soonawalla, S. Z. Zaidi, P. G. Duffy, P. G. Ransley

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: We assessed the role and long-term outcome of lower pole heminephrectomy in the treatment of nonfunctioning lower renal moieties in children with duplex kidneys. Materials and Methods: Between 1979 and 1994, 54 lower pole heminephrectomies were performed in 53 patients 1 to 192 months old (mean age 54) with duplex systems. A total of 15 patients was prenatally diagnosed, while the others presented with a urinary tract infection (36), orchiepididymitis (1) and failure to thrive (1). The surgical technique was essentially similar to that of upper pole heminephrectomy. Results: Operative course was uneventful except for intraoperative bleeding in 5 cases, which necessitated blood transfusion, and a postoperative urinary tract infection in 1. Followup ranged from 3 to 168 months (mean 56.9). Postoperative renograms available in 34 cases showed unchanged differential function in 12 and an ipsilateral 2 to 14% decrease (mean 5.65%) in 22. No late complications were detected except in 1 patient, who had postoperative urinary tract infections and subsequently underwent removal of the ureteral stump. Our series includes 4 patients with solitary ipsilateral upper poles (after the contralateral kidney was removed or nonfunctioning) who had good renal function at long-term followup despite the reduced parenchymal mass. Conclusions: Based on our experience it seems that lower pole heminephrectomy is the treatment of choice in cases of nonfunctioning dilated lower segments of duplicated kidneys.

Original languageEnglish
Pages (from-to)683-685
Number of pages3
JournalJournal of Urology
Volume156
Issue number2 SUPPL. 1
DOIs
StatePublished - Aug 1996
Externally publishedYes

Keywords

  • Kidney
  • Nephrectomy

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