A Case of Hydronephrosis Associated With Horseshoe Kidney Successfully Treated by Retroperitoneoscopic Isthmusectomy Without Pyeloplasty

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Abstract
Pyeloplasty is generally considered the standard treatment for congenital hydronephrosis associated with horseshoe kidney. We report a case successfully managed mainly by retroperitoneoscopic isthmusectomy without pyeloplasty. Case Presentation: A 23‐year‐old man presented with left flank‐to‐back pain. CT revealed horseshoe kidney and left hydronephrosis. The left ureteropelvic junction was considered compressed by renal malrotation, causing obstruction. Retroperitoneoscopic isthmusectomy was performed using an articulating endoscopic linear stapler, resulting in hydronephrosis improvement. Conclusion: In selected patients with horseshoe kidney in whom congenital hydronephrosis is primarily caused by renal malrotation associated with isthmic fusion and aberrant vessel involvement appears limited, treatment mainly consisting of retroperitoneoscopic isthmusectomy using an articulating stapling device may be effective.

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