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

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

Nephroptosis / Nephropexy / Intravenous pyelography / Hydronephrosis

Acknowledgments

None.

Statement of ethics

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The trial was conducted in accordance with the Declaration of Helsinki (as revised in 2013). This study was approved by the ethics committee of Peking University First Hospital-Miyun Hospital (no. 2023-099-001). Due to the retrospective nature of the study, the requirement for informed consent was waived.

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.

Funding source

None.

Author contributions

HL, WG, YG, XL: Conception and design;

YG, XL: Administrative support;

HL, WG, ZZ, KY, CM, BW, YH, MD, CZ, MZ, YD: Provision of study materials or patients;

WG: Collection and assembly of data;

HL, WG, KY, BW, YH, MD, XL, CZ, MZ, YD, CW, ZG: Data analysis and interpretation;

All authors: Manuscript writing, final approval of manuscript.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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