Retroperitoneoscopic nephropexy in the treatment of symptomatic nephroptosis with 2-point renal fixation.

ABSTRACT

BACKGROUND: Nephroptosis (NP), defined as a renal drop in a patient in the vertical position of at least 5 cm or the height of 2 vertebral bodies, is usually an accidental finding on intravenous urography. Only 10% of patients with NP develop clinical symptoms. Surgical treatment is applied in patients with radiologically documented pathology that causes chronic complaints and worsens the quality of life. We present the results of treatment of NP by means of retroperitoneoscopic nephropexy (Npx) with 2-point renal fixation. METHOD: Between 2003 and 2007, 21 females with a mean age of 39 years were treated for symptomatic NP by means of retroperitoneoscopic Npx. Each case of NP was confirmed by ultrasound and intravenous urography. The kidney was fixed using 2 interrupted stitches placed in the upper 1/3 part of the organ. All patients responded to the abbreviated version of the quality of life questionnaire-Short Form-36. RESULTS: Retroperitoneoscopic Npx was successfully performed in all patients. In all cases pain was relieved. Radiologic follow-up revealed subsidence of the symptoms of NP in all females. Each time the Short Form-36 questionnaire revealed improvement in all studied domains. CONCLUSIONS: Retroperitoneoscopic Npx with 2-point renal fixation is a safe and effective method of treatment in symptomatic NP.