Robot-assisted pyeloplasty for ureteropelvic junction obstruction complicating horseshoe kidney

Introduction: Horseshoe kidney is characterized by midline fusion of the lower poles of both kidneys. We report a case where robot-assisted pyeloplasty was performed for hydronephrosis complicating horseshoe kidney.

Case presentation: A 31-year-old man repeatedly developed fever since childhood. He visited a local clinic for fever and left back pain, where he was diagnosed and treated for acute pyelonephritis. Abdominal computed tomography led to a diagnosis of horseshoe kidney and associated left ureteropelvic junction obstruction. He was referred to our hospital for pyeloplasty because of persistent left back pain. Robot-assisted left pyeloplasty was performed using the Anderson-Hynes technique with four ports because crossing vessels were discovered intraoperatively. Isthmusectomy was not performed. The postoperative course was favorable. Computed tomography performed approximately 2 years post-surgery showed improvement in hydronephrosis. No left back pain was reported.

Conclusion: Our case experience suggests the utility of robot-assisted pyeloplasty for patients with horseshoe kidney.