Horse-shoe Kidney-Approach to Treatment.

ABSTRACT

Horse-shoe kidney is a congenital anomaly which is associated with calculous formation and pelviureteric junction obstruction due to the abnormal lie of the pelvis and ureters. The patient presents as pain in abdomen, recurrent urinary tract infection, lump in abdomen, haematuria and pyuria. Division of the isthmus and simultaneous nephropexy corrects the lie of the pelvis and ureters and is recommended as the surgery for symptomatic horse-shoe kidney. If the pelviureteric junction is dependent and funnel shaped, simple nephropexy in lower polar diversion position will suffice but if there is high insertion of the ureter, some form of pyeloplasty is mandatory. A contralateral nephropexy, at a later stage, is also recommended.