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Urinary Disorders

Right Ptotic Kidney

08/25/2009

Question:

Hello, recently due to the discovery of an inguinal hernia on the right side of my body, the cat scan also showed that I have a ptotic kidney in the same side. The kidney is functional but twisted, I would like eventually take care surgically to the hernia due to constant pain, was wondering if because of the ptotic kidney is there can the endoscopic surgery be used or the classic surgery will be preferred?

Answer:

Regarding the inguinal hernia, you would need to check with your surgeon who would be performing the inguinal hernia whether it can be done laparoscopically or open given the presence of the ptosed kidney. Inguinal hernia repair is usually done by general surgery and not by urology.

As far as the kidney ptosis goes, it does not need teatment if it is not causing any symptoms and is functioning well without obstruction. Sometimes the ptosed kidney (NEPHROPTOSIS) can cause symptoms/develop obtruction in certain positions, usually in erect position versus lying down position. If this is a concern, then renal scanning (nuclear medicine) needs to be performed with the patient in the erect (sitting/standing) and in the lying down (supine position) to note whether there is any alteration in the function and drainage with change in position. If the nephroptosis is causing symptoms/obstruction as proven by these scans, then it can be trated with a procedure called nephropexy (kidney is fixed to the body wall to prevent dropping down), which can be done using laparoscopy or robotic surgery.

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Response by:

Krishnanath  Gaitonde, MD Krishnanath Gaitonde, MD
Assistant Professor of Clinical Urology
College of Medicine
University of Cincinnati