1
|
Yoshida S, Matsumura M, Maekawa K, Minaga K, Kamata K, Nozawa M, Watanabe T, Kudo M. Recurrent abdominal pain caused by nephroptosis. Clin J Gastroenterol 2020; 13:621-625. [PMID: 32112340 DOI: 10.1007/s12328-020-01110-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/19/2020] [Indexed: 12/23/2022]
Abstract
Nephroptosis is a benign disorder defined as a significant descent of the affected kidney as the patient moves from supine to erect. Patients with nephroptosis sometimes manifest symptoms including abdominal pain, back pain, nausea and hematuria, while the majority of those are asymptomatic. Downward migration of the affected kidney induced by a postural change from the supine to the upright position underlies the pathophysiology of nephroptosis. The diagnosis of nephroptosis is difficult since routine imaging examinations are conducted in the supine position alone. Here, we report a case presenting recurrent abdominal pain due to unknown causes. This patient was successfully diagnosed as nephroptosis by ultrasonography and drip infusion pyelography, both of which were performed in both supine and upright positions. This case report strongly suggests that we need to take into consideration a possibility of nephroptosis when we encounter with patients complaining abdominal and/or back pain due to unknown causes.
Collapse
Affiliation(s)
- Saki Yoshida
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Mariko Matsumura
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Kiyoshi Maekawa
- Division of Ultrasound, Kindai University Hospital, Osaka-Sayama, Japan
| | - Kosuke Minaga
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Ken Kamata
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Masahiro Nozawa
- Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Tomohiro Watanabe
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
| | - Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| |
Collapse
|
2
|
Grauer R, Gray M, Schenkman N. Modified Whitaker test: a novel diagnostic for nephroptosis. BMJ Case Rep 2020; 13:13/4/e235108. [PMID: 32345588 PMCID: PMC7213707 DOI: 10.1136/bcr-2020-235108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A 77-year-old woman presented with right flank pain radiating to the ipsilateral groin and associated nausea, consistent with renal colic. In the emergency department, a non-contrast CT scan revealed severe right-sided hydronephrosis but failed to demonstrate a calculus or ureteropelvic obstruction. The patient improved with fluids and followed up with a community urologist. Initial work-up with cystoscopy and ureteroscopy, voiding cystourethrogram and diuretic renography failed to deduce a diagnosis. At our hospital, we used a modified dynamic (supine and upright) Whitaker test in a novel fashion to diagnose nephroptosis, a rare hypermobility condition of the kidney.
Collapse
Affiliation(s)
- Ralph Grauer
- Department of Urology, University of Virginia, Charlottesville, Virginia, USA
| | - Mikel Gray
- Department of Urology, University of Virginia, Charlottesville, Virginia, USA
| | - Noah Schenkman
- Department of Urology, University of Virginia, Charlottesville, Virginia, USA
| |
Collapse
|
3
|
Mogorovich A, Selli C, De Maria M, Manassero F, Durante J, Urbani L. Clinical reappraisal and state of the art of nephropexy. Urologia 2018; 85:135-144. [PMID: 29637838 DOI: 10.1177/0391560317749191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The diffusion of minimally invasive techniques for renal surgery has prompted a renewed interest in nephropexy which is indicated to prevent nephroptosis in symptomatic patients and to mobilize the upper ureter downward in order to bridge a ureteral defect. Recent publications have been reviewed to present the state of the art of the diagnosis and management of these two challenging conditions and to try to foresee the next steps. The evaluation of patients with mobile kidney can be made relying on diagnostic criteria such as ultrasound with color Doppler and measurement of resistive index, conventional upright X-ray frames after a supine uro-computerized tomography scan and both static and dynamic nuclear medicine scans, always with evaluation in the sitting or erect position. Laparoscopic nephropexy emerges as the current treatment option combining both objectively controlled repositioning of the kidney and resolution of symptoms with minimal invasiveness, low morbidity, and short hospital stay. The use of robotics is presently limited by its higher cost, but may increase in the future. Downward renal mobilization and nephropexy is a safe and versatile technique which has been adopted as a unique strategy or more often in combination with other surgical maneuvers in order to cope with complex ureteral reconstruction.
Collapse
Affiliation(s)
- Andrea Mogorovich
- 1 Division of Urology, Department of Translational Research, University of Pisa, Pisa, Italy
| | - Cesare Selli
- 1 Division of Urology, Department of Translational Research, University of Pisa, Pisa, Italy
| | - Maurizio De Maria
- 1 Division of Urology, Department of Translational Research, University of Pisa, Pisa, Italy
| | - Francesca Manassero
- 1 Division of Urology, Department of Translational Research, University of Pisa, Pisa, Italy
| | - Jacopo Durante
- 1 Division of Urology, Department of Translational Research, University of Pisa, Pisa, Italy
| | - Lucio Urbani
- 2 Department of Surgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| |
Collapse
|
4
|
Schiefer J, Amthauer H, Genseke P, Mertens PR, Chatzikyrkou C. Position-related renal perfusion disturbances as a possible underestimated mechanism in patients with resistant hypertension: a case vignette. Int Urol Nephrol 2017; 49:1823-1833. [DOI: 10.1007/s11255-017-1656-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 07/06/2017] [Indexed: 11/30/2022]
|
5
|
Arnerlöv C, Söderström M, Öhberg L. Mobile kidney pain provocation ultrasonography before surgery for symptomatic mobile kidney: A prospective study of 43 consecutive patients. Scand J Urol 2015; 50:61-4. [PMID: 26400470 DOI: 10.3109/21681805.2015.1085087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate whether mobile kidney pain provocation ultrasonography together with intravenous pyelography in supine and standing positions and a full medical history can confirm the diagnosis of the clinical condition of symptomatic mobile kidney and aid the selection of patients for surgical treatment. MATERIALS AND METHODS In a consecutive study, 43 patients with the clinical picture of symptomatic mobile kidney, a positive mobile kidney pain provocation ultrasonography and a renal descent of at least 2 lumbar vertebral heights on intravenous pyelography in the standing position, were operated on with nephropexy. Patients' pain relief after nephropexy was evaluated by clinical follow-up, a questionnaire and visual analogue scale (VAS) scoring. RESULTS Reduction of pain after nephropexy was associated with a significant decrease in VAS scoring from a median of 8 (range 4-10) preoperatively to a median of 0 (range 0-7) postoperatively (p < 0.001). Thirty-four patients (79%) were cured of their pain and seven patients (16%) experienced substantial relief from their pain symptoms. In two patients (5%) the symptoms were unchanged. CONCLUSION The results indicate that mobile kidney pain provocation ultrasonography and intravenous pyelography in supine and standing positions can verify the diagnosis of symptomatic mobile kidney and aid the selection of patients who will benefit from nephropexy.
Collapse
Affiliation(s)
- Conny Arnerlöv
- a Department of Surgical and Perioperative Sciences/Surgery , Umeå University Hospital , Umeå , Sweden
| | - Minette Söderström
- a Department of Surgical and Perioperative Sciences/Surgery , Umeå University Hospital , Umeå , Sweden
| | - Lars Öhberg
- b Department of Diagnostic Radiology , Umeå University Hospital , Umeå , Sweden
| |
Collapse
|
6
|
Khodarahmi I, Goldman AR. Transient Rotation of a Non-ptotic Kidney Secondary to Acute Pulmonary Thromboembolism. J Clin Imaging Sci 2014; 4:69. [PMID: 25806127 PMCID: PMC4286817 DOI: 10.4103/2156-7514.148263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 11/12/2014] [Indexed: 11/05/2022] Open
Abstract
We present a case of an acquired, transient, rotated right kidney in a 43-year-old woman with an enterocutaneous fistula who presented with acute pulmonary embolism. This non-ptotic rotated kidney returned to its normal orientation within 10 days. We postulate that this transient kidney rotation is due to transient hepatomegaly and passive renal congestion secondary to pulmonary embolism. While in this patient there were no untoward sequelae, it has been reported that ureteral obstruction or vascular occlusion can occur in patients with ptotic and malrotated kidneys, and radiologists, therefore, should be aware of this unusual occurrence and the potential complications.
Collapse
Affiliation(s)
- Iman Khodarahmi
- Department of Radiology, Rutgers, The State University of New Jersey, Newark, New Jersey, USA
| | - Alice R Goldman
- Department of Radiology, Rutgers, The State University of New Jersey, Newark, New Jersey, USA
| |
Collapse
|
7
|
Abstract
BACKGROUND Nephroptosis is a clinical condition characterized by an abnormal caudal movement of the kidney that descends more than 2 vertebral bodies (or more than 5 cm) during a position change from supine to upright. In the last decade, the availability of laparoscopic surgery has led to a revival of interest in nephroptosis and nephropexy. We describe our technique for transperitoneal laparoscopic robotic-assisted nephropexy. METHODS The surgery was performed on a 78-year-old woman with a BMI of 18 and ASA 2. The diagnosis of nephroptosis was preoperatively confirmed by excretory urography in the supine and upright positions. The patient was placed in Trendelemburg position on the left side. The laparoscopic surgery was performed, through a transperitoneal approach, using the daVinci system: the ptosic kidney was fixed using two separated stiches of non-absorbable prolene 2.0 between the superior surface of the kidney and the quadratus lumborum muscle. The sutures were fixed using Hem-o-lok clips. RESULTS Intra- or post-operative complications have not occurred. The effectiveness of treatment was demonstrated by an intravenous urography 60 days after. CONCLUSIONS Robotic-assisted nephropexy is a safe and effective procedure that leads to both clinical and aesthetic excellent results, comparable to the ones obtained with the laparoscopic approach for the treatment of symptomatic renal ptosis. The robotic-assisted nephropexy appears to be easier, with the particular advantages of the intracorporeal suturing and a better intraoperative view; the sliding-clips method allows reducing the organ trauma to the minimum.
Collapse
|
8
|
Castle SM, Karnjanawanichkul W, Leveillee RJ. Application of "cinch/tie" technique to robotic-assisted nephropexy for posterior abdominal wall fixation. J Robot Surg 2012; 6:155-7. [PMID: 27628279 DOI: 10.1007/s11701-010-0237-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Accepted: 12/04/2010] [Indexed: 11/25/2022]
Abstract
Nephropexy remains standard for symptomatic nephroptosis, and several minimally-invasive techniques have been described. Triangulation sutures placed between the abdominal wall and the renal capsule are often difficult to tie tightly due to the confined working space. We propose a technique modification to fixate the kidney utilizing the da Vinci Surgical System robot and Lapra-Ty absorbable suture clips. Four female patients with symptomatic nephroptosis diagnosed via kidney hypermobility demonstrated on intravenous urography (IVU) underwent robotic-assisted laparoscopic nephropexy (RALNP) from February 2008 to April 2010. After complete mobilization and stripping of perirenal fat, several 0 Vicryl sutures were placed in a "figure of eight" fashion and tied loosely. Subsequently we utilized a Lapra-Ty to tighten the stitch serially and fixate the kidney. The mean age was 46 years (43-52); one patient underwent simultaneous pyeloplasty and one underwent partial nephrectomy in the ipsilateral kidney. There were no intraoperative complications and two postoperative complications, both Clavien grade I. All patients were asymptomatic postoperatively at a mean follow-up of 9.2 months (1-28), and had no evidence of kidney hypermobility on upright IVU or diuretic renal scintigraphy (RS) scan at 6 weeks postoperatively. RALNP is a viable option in the treatment of symptomatic nephroptosis. Secure placement of several "pexing" sutures helps to ensure appropriate security of these itinerant kidneys. Our technique modification corrects kidney hypermobility while improving symptoms related to nephroptosis.
Collapse
Affiliation(s)
- Scott M Castle
- Department of Urology, Division of Endourology, Miller School of Medicine, University of Miami, 1400 NW 10th Ave, Ste 509, Miami, FL, 33136, USA.
| | - Watid Karnjanawanichkul
- Department of Urology, Division of Endourology, Miller School of Medicine, University of Miami, 1400 NW 10th Ave, Ste 509, Miami, FL, 33136, USA
| | - Raymond J Leveillee
- Department of Urology, Division of Endourology, Miller School of Medicine, University of Miami, 1400 NW 10th Ave, Ste 509, Miami, FL, 33136, USA
| |
Collapse
|
9
|
Abstract
MATERIALS AND METHODS Laparoscopic nephropexy was performed in 8 consecutive cases with symptomatic nephroptosis through suturing and fixation of a polyprolene mesh between the posterior surface of the kidney and quadratus lumborum muscle. All patients had symptomatic nephroptosis. Preoperatively, intravenous urography and a split renal scan in supine and upright positions were done for all patients. RESULTS The operation was successfully completed laparoscopically in all cases with a mean operative time of 135 minutes without major perioperative complications. The median blood loss was 60 mL. Hospital stay was 3.2 days (range, 2 to 6 d). Seven cases improved significantly after operation in a mean follow-up of 1.5 years. The success rate of this study is 87.5%. CONCLUSIONS Laparoscopic nephropexy using polyprolene mesh is a minimally invasive, suitable, and clinically established procedure for the treatment of symptomatic nephroptosis with good results in comparison with open surgery.
Collapse
|
10
|
Buffardi A, Ceruti C, Destetan P, Ruffino M, Bosio A, Bisconti A, De Maria C, Negro C, Carchedi M, Fontana D. Nefropessi Retroperitoneoscopica. Urologia 2010. [DOI: 10.1177/0391560310077016s04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Nephroptosis has been defined as renal descent of 5 or more cm on orthostasis. This disease is more frequent in young and slim women. The patient complains pain in upright position, that regress lying down. The therapy consists of surgical treatment. We report the case of a woman treated with retroperitoneoscopic nephropexy. Methods We present the case of a 25–years old woman, affected by lumbar pain in upright position for about 1 year. Ultrasound scan of the abdomen and RX-KUB did not show hydronephrosis nor stones. Both an orthopedic examination and a spinal MRI excluded bone or muscular diseases. Intravenous pyelography and diuretic isotope renography in upright position revealed a renal descent of more than 5 cm, without obstruction of upper urinary tract. The patient underwent a renal color doppler imaging, that showed reduction of right kidney resistive index in upright position. The patient underwent a right retroperitoneoscopic nephropexy. After complete dissection of the perirenal fat from the kidney, three nonabsorbable sutures were placed between the posterior renal capsule and the psoas muscle. Results NO blood loss nor perioperative complications have been observed. One month after the procedure, the patient did not complain any pain. Renal color doppler, performed one month after the nephropexy, showed a normalization of resistive index. Conclusions Symptomatic nephroptosis is a disease that has been questioned in the past. Nowadays, the modern imaging and functional examination available allow to identify the “true” cases of symptomatic nephroptosis. The treatment with retroperitoneoscopic nephropexy is an easy and effective procedure.
Collapse
Affiliation(s)
- A. Buffardi
- Divisione Universitaria di Urologia 2 - Ospedale San Giovanni Battista “Molinette “ - Torino
| | - C. Ceruti
- Divisione Universitaria di Urologia 2 - Ospedale San Giovanni Battista “Molinette “ - Torino
| | - P. Destetan
- Divisione Universitaria di Urologia 2 - Ospedale San Giovanni Battista “Molinette “ - Torino
| | - M.A. Ruffino
- Divisione di Radiologia Diagnostica 6 - Ospedale San Giovanni Battista “Molinette “ - Torino
| | - A. Bosio
- Divisione Universitaria di Urologia 2 - Ospedale San Giovanni Battista “Molinette “ - Torino
| | - A. Bisconti
- Divisione Universitaria di Urologia 2 - Ospedale San Giovanni Battista “Molinette “ - Torino
| | - C. De Maria
- Divisione Universitaria di Urologia 2 - Ospedale San Giovanni Battista “Molinette “ - Torino
| | - C. Negro
- Divisione Universitaria di Urologia 2 - Ospedale San Giovanni Battista “Molinette “ - Torino
| | - M. Carchedi
- Divisione Universitaria di Urologia 2 - Ospedale San Giovanni Battista “Molinette “ - Torino
| | - D. Fontana
- Divisione Universitaria di Urologia 2 - Ospedale San Giovanni Battista “Molinette “ - Torino
| |
Collapse
|
11
|
Abstract
BACKGROUND A 25-year-old woman was evaluated repeatedly from 10 months following her first pregnancy and delivery for recurrent episodes of lower right quadrant abdominal pain, hematuria and a sensation of mass. Despite investigations by several physicians over a 7 month period no clear diagnosis had been made, but a psychosomatic disorder or possible periodic blocked bowel had been suggested, after which the patient requested a consultation with a nephrologist. Her history indicated joint laxity syndrome and a mitral valve prolapse. She was undergoing continuing evaluation for a possible rheumatic condition. INVESTIGATIONS Full history, physical examination, and intravenous pyelography. DIAGNOSIS Nephroptosis of the right kidney. INTERVENTION Exercises were prescribed to strengthen her abdominal musculature and she was advised to wear an elastic abdominal corset during the daytime. The patient is currently considering surgical intervention.
Collapse
|
12
|
Retroperitoneoscopic nephropexy in the treatment of symptomatic nephroptosis with 2-point renal fixation. Surg Laparosc Endosc Percutan Tech 2009; 19:356-9. [PMID: 19692892 DOI: 10.1097/sle.0b013e3181a86753] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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.
Collapse
|
13
|
|
14
|
El-Moula MG, Izaki H, Kishimoto T, Takahashi M, Fukumori T, Kanayama HO. Laparoscopic nephropexy. J Laparoendosc Adv Surg Tech A 2008; 18:230-6. [PMID: 18373449 DOI: 10.1089/lap.2007.0110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIM We evaluated the safety and efficacy of laparoscopic nephropexy for symptomatic nephrotosis. PATIENTS AND METHODS Between May 2000 and December 2005, 6 women (mean age, 43.1 years) underwent laparoscopic nephropexy of 8 kidneys (6 right, 2 left). Mean body mass index was 19.6 kg/m(2). Two patients displayed ureteropelvic junction obstruction (UPJO). Preoperative evaluation was performed by intravenous urography (IVU) and isotope renography in both the supine and erect positions. Four patients (6 renal units) underwent retroperitoneoscopic nephropexy, with a dismembered pyeloplasty in 1 patient (1 renal unit). The transperitoneal approach was performed in 2 patients, the first case and another with UPJO due to an aberrant vessel. The kidney was mobilized, then fixed to the back muscles with nonabsorbable sutures. RESULTS Mean operative time was 139.4 minutes (range, 95-200), and mean blood loss was 30 mL (range, 10-60). No perioperative complications were encountered. Mean hospital stay was 6.4 days. Postoperative IVU and isotope renography correctly confirmed a fixed kidney and no obstruction in the UPJO cases. All patients reported a symptomatic improvement during follow-up (range, 11-81 months). CONCLUSIONS As pain is the presenting symptom in these cases, a laparoscopic approach seems to represent the gold standard for treatment owing to low morbidity and good cosmetic results.
Collapse
Affiliation(s)
- Mohamed Gad El-Moula
- Department of Urology, The University of Tokushima Graduate School of Medicine, Institute of Health Biosciences, Tokushima, Japan
| | | | | | | | | | | |
Collapse
|
15
|
Chekulaev D, Dayma T, Abecassis JP, Peyromaure M. Case report: Three-trocar technique for bilateral laparoscopic nephropexy. J Endourol 2007; 21:59-61. [PMID: 17263609 DOI: 10.1089/end.2006.0061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Nephroptosis is a rare syndrome, which affects the right kidney in the majority of cases. In the current report, a case of bilateral nephroptosis with an unusual presentation is presented. We performed bilateral laparoscopic nephropexy using a three-trocar approach. The intervention was successful, with a short operative time and minimal blood loss. The clinical presentation of our patient and the surgical technique for bilateral laparoscopic nephropexy are described.
Collapse
|
16
|
LiteratureWatch, July-December 2004. J Endourol 2005; 19:253-63. [PMID: 15798428 DOI: 10.1089/end.2005.19.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|