Ectopic pelvic kidney: Prenatal diagnosis and management

Abstract

Objective: Ectopic pelvic kidney (EPK) is one of the most frequent renal anomalies detected in newborns as 1/500–700. Although it is generally asymptomatic, its association with recurrent urinary infections, vesicoureteral reflux, predisposition to stone formation, and genital anomalies has been shown. This study aimed to present the prenatal findings and postnatal outcomes of cases diagnosed with unilateral EPK. Material and Methods: Twelve cases were recruited for this study between January 2018 and June 2020 in Van Training and Research Hospital. EPK diagnosis was achieved if the kidney was located in the pelvis, the separation of the kidney-specific cortex-medulla was present, and the renal pelvis was detected. EPK diagnosis was confirmed by renal USG in all cases postnatally. Long-term results of all cases were analyzed retrospectively from patients records. Statistical analysis was achieved by calculating the mean and standard deviation values with the Statistical Package for Social Sciences (SPSS 20), Chicago, USA. Results: Mean gestational age at diagnosis week was 25.2±4.2 weeks. Left EPK was detected in 7 (58.3%) and right EPK in 5 (41.7%) cases. Pelvis dilatation was detected in EPK in 2 (16.6%) cases and the kidney versus 3 (25%) fetuses. An additional structural anomaly was observed in 1 (8.3%) case. A genital anomaly was not observed in any case during the prenatal period. The mean follow-up interval was 11.2±2.8 months. 7 (58.3%) were female, and 5 (41.7%) were male. Renal functions were normal in all cases. A total of 3 (25%) cases, including Grade-1 vesicoureteral reflux in one case, recurrent urinary infection in 1 case, and hypospadias in one case, anomaly associated with EPK was detected. Conclusion: The presence of EPK should be investigated in all fetuses with an empty renal fossa in the prenatal period. All cases should be followed up after delivery in terms of accompanying anomalies.