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I./4.6.: Therapy
An asymptomatic horshoe kidney does not need any treatment,but due to the higher incidence of neoplastic formations regular US follow up is required Recommendations concerning the frequency of the check ups vary between centers. As horseshoe kidney predisposes to stone formation every attempt should be made to prevent it, by appropriate fluid intake and diet. Metabolic risk factors should be diagnosed and treated. Symptomatic cases are treated according to the specific underlying cause. Urine infections need targeted antibiotic therapy, an obstruction might need surgical intervention. If the obstruction is between the pyelon and the ureter endoscopic pyeloplasty can be done.
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In cases of stone formation the most often used technique is ESWL (extracorporal shockwave lithotripsy), when the stones are smashed into small pieces by using ultrasound waves. The small calculi then spontaneusly flow out with urine.This method is contraindicated with proven pyelectasia. Open or endoscopic surgical stone resection are the alternatives to this method. Surgical planning for retroperitoneal operations for other causes in patients with horseshoe kidney requires special attention to vascular supply. An angiography offers enough information about the variability of the vascular supply of the horseshoe kidney.
Horseshoe kidney can be used as transplant as a whole or by dividing it into two pieces. In the latter case the probability of fistule formation is higher.
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Utolsó módosítás: 2014. January 14., Tuesday, 11:14