1. Ahmad Hanno
Professor of Urology
Head of Pediatric Urology

2. 1. Number
2. Size and structure
3. Rotation
4. Location
5. Fusion

3. 1. Unilateral Renal agensis
2. Bilateral renal agnesis

4.  Incompatible with life
 Severe oligohydraminos
 Potter’s syndrome (flattened facies, wide nasal bridge,
hypoplastic lungs, club foot)

6.  Incidence 1 in 1000
 Absent ureteric bud
 Asymptomatic
 Compensatory hypertrophy of contralateral kidney

7. 1. Hypoplastic kidney
2. Polycystic kidney
3. Multicystic dysplastic kidneys

8.  Small kidney, less no of nephrons
 Renal vessels and ureter…. Somewhat underdeveolped
 Treatment….. Depends
 Nephrectomy only if complicated
 Renovascular hypertension

12.  Adult: autosomal dominant
 Infantile: autosomal recessive

19.  Polycystic: non-communicating cysts, intervening
parenchyma
 Multicystic dysplastic: non-communicating, variable
sized, no intervening parenchyma, function nearly
zero

20. 1. Malrotated kidneys

21.  Pelvis directed anteriorly (instead of medially)
 Calyces directed posteriorly ( laterally)
 Asymptomatic

23.  RENAL ECTOPIA
1. Simple renal ectopia
2. Crossed renal ectopia

24.  Failure of normal ascent of the kidney to its normal
lumbar location
 Commonest: Pelvic kidney

25.  Asymptomatic
 ?? Palpable ( superficial location) in iliac fossa
 Malrotated, short ureter
 Blood supply : iliac vessels, other surrounding vessels

26.  DD
 Nephroptosis
 Rx….. Nephropexy

29.  Kidney crosses midline, to the other side
 Fused or non fused
 Ureter crosses to normal location at the bladder

31. 1. Horse shoe kidney
2. Crossed fused renal ectopia

32.  Lower poles are connected by an isthmus
 Malrotated kidneys
 Lower level than normal (inferior mesenteric artery)
 Longitudinal axis… downwards and medially
 Lower calyces …. Directed medially

35.  Asymptomatic
 No Rx
 More liable for stones, PUJO

36.  PUJO
 Ureteral duplication
 Ureterocele
 VUR

38. Causes of PUJ Obstruction
Intrinsic Stenosis
Ureteric Folds

39. Lower pole vessels
Horseshoe
Kidney

46.  Complete
1. Upper….. Lower & medial location
2. Lower….. Upper & lateral location
 Incomplete

48.  A ureterocoele is a cystic dilatation of the lower end of
the ureter.
 Herniation of urotheliun of the submucosal ureter.
 Occurs with a single system or double system.
 May be located in the bladder, or it may open in an
ectopic location below the bladder neck

50.  Rx
 Incision…… septic
 Excision
 Upper partial nephrectomy