V7-12: ROBOTIC-ASSISTED LAPAROSCOPIC LEFT NEPHROURETERECTOMY OF AN ECTOPIC KIDNEY IN THE MALE PEDIATRIC PATIENT

Video

INTRODUCTION

Ectopic ureteral insertion is a rare condition. Ectopic ureters in males may present with flank pain, lower urinary tract symptoms, or epididymoorchitis. We present a case of a male patient with a dysplastic, ectopic, left kidney with an ectopic ureter managed with robotic-assisted laparoscopic nephroureterectomy._x000D_ _x000D_

METHODS

A 10 year old male presented with chronic, left epididymal pain. Urinalysis was unremarkable. The patient was born with a solitary functioning right kidney detected on prenatal ultrasound. Additionally, he had a known left sided pelvic cyst, consistent with a nonfunctioning, ectopic, left kidney. The ectopic, dysplastic, left kidney had been followed with regular ultrasounds and the dilated renal pelvis had increased in size by 8 mm over the last five years. Routine ultrasound demonstrated a 4.5 cm, tubular, cystic structure behind the bladder. Follow up MRI revealed an atrophic, ectopic, dilated left kidney with ectopic ureter inserting into the left seminal vesicle. The patient was taken for robotic assisted laparoscopic left nephroureterectomy.

RESULTS

Pathologic analysis revealed an ectopic ureter with associated epithelial-lined cyst. No renal parenchyma was identified in the pathologic specimen. There were no complications. Estimated blood loss was 20 milliliters. The patient was dismissed from the hospital on postoperative day 1.

CONCLUSION

Robotic-assisted laparoscopy proved to be a safe and efficacious platform for dissection and removal of an ectopic, nonfunctioning kidney with an ectopic ureter draining into the seminal vesicle. All structures were accessed from a single docking point, and the procedure was well-tolerated, providing a minimally-invasive option for management of this congenital abnormality.

Funding: None