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Double renal pelvis — Clinical Guidelines

Overview

Double renal pelvis refers to an anatomical anomaly where the renal pelvis bifurcates into two separate channels, potentially complicating diagnosis and management of urological conditions such as neoplasms and calculi. 1 3 5

Diagnosis

Imaging studies (CT, MRI) essential for identifying anatomical variations and associated pathologies.

Histopathological examination required for diagnosing neoplasms like mucinous adenocarcinoma or carcinosarcoma 2 5 6.

Endoscopic procedures may aid in diagnosis and management of papillary neoplasms 4.

Management

Reconstruction techniques: Free peritoneal patch can be used for renal pelvis repair when simple closure is not feasible 1.

Endoscopic approaches: Endoscopic lower ureterectomy may be effective for localized papillary neoplasms 4.

Surgical resection: Primary treatment for malignancies such as mucinous adenocarcinoma and carcinosarcoma, often requiring nephrectomy 2 5 6.

Special Populations

Pregnancy: No specific guidelines provided in abstracts.

Pediatrics: No specific guidelines provided in abstracts.

Elderly: Management should consider comorbidities and functional status, though specific recommendations are lacking 1 3 5 6.

Comorbidities: Presence of severe pyelonephritis or staghorn calculi may influence treatment approach for malignancies 5.

Key Recommendations

Utilize imaging studies (CT, MRI) for accurate diagnosis of double renal pelvis and associated conditions (Evidence: Moderate 1 3).

Employ endoscopic techniques for localized neoplasms when feasible, complemented by surgical resection for malignancies (Evidence: Weak 4 2 5 6).

Consider reconstructive techniques like free peritoneal patching for complex pelvic repairs (Evidence: Weak 1).

References

1 Lanza P, Falvo F, Spasari A, Lanza T. Renal pelvis reconstruction with a free peritoneal patch. European urology 1985. link 2 Mirone V, Prezioso D, Palombini S, Lotti T. Mucinous adenocarcinoma of the renal pelvis. European urology 1984. link 3 Blacklock AR, Geddes JR, Black JW. Mucinous and squamous metaplasia of the renal pelvis. The Journal of urology 1983. link51295-1) 4 Heslop R. Endoscopic lower ureterectomy. Annals of the Royal College of Surgeons of England 1982. link 5 Joshi K, Jain K, Mathur S, Mehrotra GC. Mucinous adenocarcinoma of the renal pelvis. Postgraduate medical journal 1980. link 6 Ridolfi RL, Eggleston JC. Carcinosarcoma of the renal pelvis. The Journal of urology 1978. link57552-7)

Double renal pelvis