Laparoscopic nephrolithotomy in a patient with crossed fused renal ectopia.

BACKGROUND: A 32-year-old man was referred to a tertiary care center for stone management. The patient had initially presented to his primary physician 3 months earlier with right flank pain of 2 month's duration. Abdominopelvic ultrasonography and intravenous urography had revealed left-to-right crossed fused renal ectopia with a 25 mm opaque stone in the crossed kidney. The patient had received two sessions of extracorporeal shock wave lithotripsy, which had failed to remove the renal stone. INVESTIGATIONS: Noncontrast CT, blood tests (hemoglobin and creatinine levels), abdominopelvic ultrasonography and intravenous urography. DIAGNOSIS: Left-to-right crossed fused ectopia with a 25 mm opaque renal stone in the anomalous kidney. MANAGEMENT: The patient underwent laparoscopic nephrolithotomy to remove the renal stone. Intravenous urography and abdominopelvic ultrasonography 1 month after surgery confirmed that the patient was stone free and had functional renal units. The patient will be followed up every 3 months with abdominopelvic ultrasonography for early detection of stone recurrence.