成人巨大水腎症に腎保存的手術を行った1例 : 腎保存手術適応に関する検討

Abstract

A 40-year-old man with the complaint of right lower abdominal pain was admitted to our hospital. Urological examinations revealed right giant hydronephrosis and ureteropelvic junction (UPJ) obstruction caused by an aberrant artery. Radiography showed approximately 3, 500 ml of fluid in the renal pelvis. Preliminary nephrostomy was performed and about 2, 300 ml of fluid was removed. Enhanced computed tomography, angiography, radioisotope examination and pelvic urine analysis indicated that conservative operation in this case was possible and a pyeloplasty was performed. Two years after the operation the right renal function showed improvement with no complication of hypertension. Although nephrectomies have been performed in adult cases with giant hydronephrosis it is important to consider indication for conservative operations in those cases.