Laparoscopic nephrectomy for xanthogranulomatous pyelonephritis in the absence of kidney stones or clinical urinary infection.

Here, we present a patient who underwent transperitoneal laparoscopic nephrectomy for a nonfunctional kidney on the left side, and who was found to have xanthogranulomatous pyelonephritis (XGP) on the subsequent histopathology examination. XGP is a severe, chronic infection of the renal parenchyma. Nephrectomy is the treatment of choice. Preoperative diagnosis of XGP can be challenging because the clinical presentation may vary. Our patient's loss of kidney function was due to a simple cortical kidney cyst that compressed the urinary collecting system. He presented only with mild flank pain and a poorly functioning kidney, and therefore XGP was not suspected before surgery. Because of the renal and perirenal inflammatory changes that commonly accompany XGP, the laparoscopic approach is difficult and is therefore rarely used. However, laparoscopic nephrectomy for XGP offers an easier recovery for the patient and therefore deserves further consideration as a method of treatment.