{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T19:34:44Z","timestamp":1788636884239,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This study evaluates and compares the surgical outcomes of open pyelolithotomy, laparoscopic pyelolithotomy, and retrograde intrarenal surgery (RIRS) in the management of pelvic ectopic kidney stones. Methods: A retrospective analysis was conducted on 47 adult patients with pelvic ectopic kidney stones who underwent surgery between January 2009 and January 2024. Patients were categorized as open pyelolithotomy (n = 15), laparoscopic pyelolithotomy (n = 14), or RIRS (n = 18). Stone-free (SF) rates were assessed in the early postoperative period (1st or 2nd day), in the 1st month, and in the 3rd month. Demographic data, stone characteristics, operative data, and complications were recorded. Results: RIRS had significantly shorter operative and hospitalization times but a lower SF rate in the 3rd month (44.4%) compared to laparoscopy (92.9%) and open pyelolithotomy (86.7%). Additional procedures were required in 50% of RIRS cases to achieve SF status, while none were needed in the other groups. Complications included three Grade 2 cases (two bleeding; transient creatinine elevation) in open pyelolithotomy, two Grade 2 (urinary leakage; infection) and two Grade 3 cases (conversion to open surgery; trapped stent removal) in laparoscopic pyelolithotomy, and one Grade 2 case (febrile infection) in RIRS. Conclusions: Laparoscopic pyelolithotomy demonstrated the highest efficacy and comparable complication rates; making it the preferred approach for pelvic ectopic kidney stones. Open pyelolithotomy remains a valuable alternative where laparoscopic expertise or resources are limited. Although less invasive, RIRS showed lower efficacy due to the challenging anatomy of pelvic ectopic kidneys.<\/jats:p>","DOI":"10.3390\/jcm14062081","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T06:10:53Z","timestamp":1742364653000},"page":"2081","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcomes of the Surgical Stone Management in Pelvic Ectopic Kidneys: A Retrospective Comparison of Three Different Approaches"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7175-713X","authenticated-orcid":false,"given":"Fatih","family":"Bicaklioglu","sequence":"first","affiliation":[{"name":"Department of Urology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul 34865, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8052-5437","authenticated-orcid":false,"given":"Mahmut Selman","family":"Mert","sequence":"additional","affiliation":[{"name":"Department of Urology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul 34865, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6219-9655","authenticated-orcid":false,"given":"Resul","family":"Sobay","sequence":"additional","affiliation":[{"name":"Department of Urology, Istanbul Umraniye Training and Research Hospital, University of Health Sciences, Istanbul 34766, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozgur","family":"Arikan","sequence":"additional","affiliation":[{"name":"Department of Urology, Goztepe Prof. Dr. Suleyman Yalc\u0131n City Hospital, Medeniyet University, Istanbul 34722, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet Erhan","family":"Aydin","sequence":"additional","affiliation":[{"name":"Department of Urology, Eskisehir City Hospital, Eskisehir 26080, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Uslu","sequence":"additional","affiliation":[{"name":"Department of Urology, Kafkas University School of Medicine, Kars 36100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5336-7311","authenticated-orcid":false,"given":"Salih","family":"Yildirim","sequence":"additional","affiliation":[{"name":"Department of Urology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul 34098, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kemal","family":"Sarica","sequence":"additional","affiliation":[{"name":"Department of Urology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul 34098, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Brockwell, M., Hergenrother, S., Satariano, M., Shah, R., and Raina, R. (2024). Pathophysiology of Congenital Anomalies of the Kidney and Urinary Tract: A Comprehensive Review. Cells, 13.","DOI":"10.3390\/cells13221866"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Pavlovi\u0107, N., Kelam, N., Racetin, A., Filipovi\u0107, N., Pogoreli\u0107, Z., Prusac, I.K., and Vukojevi\u0107, K. (2024). Expression Profiles of ITGA8 and VANGL2 Are Altered in Congenital Anomalies of the Kidney and Urinary Tract (CAKUT). Molecules, 29.","DOI":"10.3390\/molecules29143294"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1089\/end.1996.10.379","article-title":"Value of laparoscopy in the management of calculi complicating renal malformations","volume":"10","author":"Zafar","year":"1996","journal-title":"J. Endourol."},{"key":"ref_4","first-page":"935","article-title":"Ectopic kidney: A review of 97 cases","volume":"64","author":"Thompson","year":"1937","journal-title":"Surg. Gynecol. Obstet."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1089\/end.1994.8.179","article-title":"Extracorporeal shockwave lithotripsy in anomalous kidneys","volume":"8","author":"Baltaci","year":"1994","journal-title":"J. Endourol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1089\/end.1999.13.349","article-title":"Extracorporeal shockwave lithotripsy in anomalous kidneys","volume":"13","author":"Isen","year":"1999","journal-title":"J. Endourol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/S0022-5347(17)47274-0","article-title":"Percutaneous transperitoneal approach to a pelvic kidney for endourological removal of staghorn calculus","volume":"134","author":"Eshghi","year":"1985","journal-title":"J. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1016\/S0022-5347(01)66078-6","article-title":"Laparoscopic pyelolithotomy for calculus removal in a pelvic kidney","volume":"155","author":"Harmon","year":"1996","journal-title":"J. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1089\/end.2000.14.289","article-title":"Percutaneous nephrolithotripsy in ectopic kidneys","volume":"14","author":"Desai","year":"2000","journal-title":"J. Endourol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.urology.2004.09.055","article-title":"Ureteroscopic management of renal calculi in anomalous kidneys","volume":"65","author":"Weizer","year":"2005","journal-title":"Urology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1186\/s13256-022-03345-3","article-title":"Robotic pyelolithotomy in a solitary pelvic kidney complicated with fulminant Clostridium difficile: A case report","volume":"16","author":"Kerr","year":"2022","journal-title":"J. Med. Case Rep."},{"key":"ref_12","unstructured":"EDN (2023, January 10\u201313). EAU Guidelines. Proceedings of the EAU Annual Congress Milan 2023, Milan, Italy."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/j.1442-2042.2004.00916.x","article-title":"Stones in anomalous kidneys: Results of treatment by shock wave lithotripsy in 150 patients","volume":"11","author":"Tunc","year":"2004","journal-title":"Int. J. Urol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3963","DOI":"10.21608\/ejhm.2019.41909","article-title":"Outcome of extracorporeal shockwave lithotripsy in congenital malformed kidneys","volume":"76","author":"Ahmad","year":"2019","journal-title":"Egypt. J. Hosp. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1089\/lap.1998.8.431","article-title":"Laparoscopically assisted percutaneous transperitoneal nephrolithotomy in pelvic dystopic kidneys: Experience in 15 successful cases","volume":"8","author":"Holman","year":"1998","journal-title":"J. Laparoendosc. Adv. Surg. Tech. A"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.urology.2014.08.015","article-title":"Percutaneous nephrolithotomy in pelvic kidneys: Is the ultrasound-guided puncture safe?","volume":"85","author":"Jairath","year":"2015","journal-title":"Urology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.aju.2012.03.004","article-title":"The role of open stone surgery","volume":"10","author":"Buchholz","year":"2012","journal-title":"Arab. J. Urol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"101528","DOI":"10.1016\/j.eucr.2020.101528","article-title":"Open pyelolithotomy in an ectopic kidney: A case report","volume":"35","author":"Patandung","year":"2020","journal-title":"Urol. Case Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"287","DOI":"10.3889\/oamjms.2021.7748","article-title":"Open Pyelolithotomy in a Pelvic Ectopic Kidney: Case Report and Current Literature Review","volume":"9","author":"Hadisuryo","year":"2021","journal-title":"Open Access Maced. J. Med. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1089\/end.2000.14.829","article-title":"Laparoscopic surgery for renal urolithiasis: Pyelolithotomy, caliceal diverticulectomy, and treatment of stones in a pelvic kidney","volume":"14","author":"Ramakumar","year":"2000","journal-title":"J. Endourol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1089\/end.2010.0521","article-title":"Laparoscopic pyelolithotomy in selected patients with ectopic pelvic kidney: A feasible minimally invasive treatment option","volume":"25","author":"Elbahnasy","year":"2011","journal-title":"J. Endourol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.kjms.2017.01.003","article-title":"Surgical management of urinary stones with abnormal kidney anatomy","volume":"33","author":"Ergin","year":"2017","journal-title":"Kaohsiung J. Med. Sci."},{"key":"ref_24","first-page":"e65406","article-title":"Transperitoneal Laparoscopic Pyelolithotomy in Pelvic Ectopic Kidneys: Experience from a Northern Indian Tertiary Care Institution","volume":"16","author":"Aggarwal","year":"2024","journal-title":"Cureus"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/S0210-4806(04)73146-0","article-title":"Pielolitotom\u00eda laparosc\u00f3pica en ri\u00f1\u00f3n pelviano [Laparoscopic pyelolithotomy in a pelvic kidney]","volume":"28","year":"2004","journal-title":"Actas Urol. Esp."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"537","DOI":"10.23736\/S0393-2249.19.03432-5","article-title":"Robotic pyelolithotomy for the treatment of large renal stones: A single-center experience","volume":"71","author":"Zazzara","year":"2019","journal-title":"Minerva Urol. Nefrol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1016\/j.urology.2014.07.041","article-title":"Flexible ureterorenoscopy for the treatment of kidney stone within pelvic ectopic kidney","volume":"84","author":"Bozkurt","year":"2014","journal-title":"Urology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"557","DOI":"10.25122\/jml-2021-0251","article-title":"Single-use ureteroscopes in ectopic pelvic kidney stones","volume":"14","author":"Geavlete","year":"2021","journal-title":"J. Med. Life"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.urology.2017.08.035","article-title":"Ureteroscopic Urinary Stone Treatment Among Patients with Renal Anomalies: Patient Characteristics and Treatment Outcomes","volume":"110","author":"Legemate","year":"2017","journal-title":"Urology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"226","DOI":"10.3897\/folmed.65.e77728","article-title":"The role of retrograde intrarenal surgery in kidney stones of upper urinary system anomalies","volume":"65","author":"Ozmerdiven","year":"2023","journal-title":"Folia Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.urology.2012.02.072","article-title":"A new scoring system for predicting stone-free rate after retrograde intrarenal surgery: The \u201cresorlu-unsal stone score\u201d","volume":"80","author":"Resorlu","year":"2012","journal-title":"Urology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1007\/s11255-016-1311-2","article-title":"External validation of Resorlu-Unsal stone score as predictor of outcomes after retrograde intrarenal surgery","volume":"48","author":"Sfoungaristos","year":"2016","journal-title":"Int. Urol. Nephrol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"311","DOI":"10.4081\/aiua.2022.3.311","article-title":"External validation of Resorlu-Unsal stone score in predicting outcomes after retrograde intrarenal surgery. Experience from a single institution","volume":"94","author":"Tufano","year":"2022","journal-title":"Arch. Ital. Urol. Androl."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s00345-025-05520-9","article-title":"Is flexible navigable suction ureteral access sheath (FANS) safer and more efficient than conventional sheaths? Italian multicentric experience","volume":"43","author":"Cacciatore","year":"2025","journal-title":"World J. Urol."},{"key":"ref_35","first-page":"85","article-title":"Application of laser technology in urinary stone treatment","volume":"67","author":"Cauni","year":"2022","journal-title":"Rev. Roum. Des. Sci. Tech. S\u00e9rie \u00c9lectrotechnique \u00c9nerg\u00e9tique"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/6\/2081\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:56:16Z","timestamp":1760028976000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/6\/2081"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,19]]},"references-count":35,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["jcm14062081"],"URL":"https:\/\/doi.org\/10.3390\/jcm14062081","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,19]]}}}