{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:59:17Z","timestamp":1775091557432,"version":"3.50.1"},"reference-count":29,"publisher":"PAGEPress Publications","issue":"1","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Background: Horseshoe kidney (HSK) and pelvic ectopic kidney (PEK) are congenital anomalies linked to impaired urinary drainage and a higher risk of nephrolithiasis. Evidence regarding metabolic profiles and surgical outcomes in these groups remains sparse. This study assessed predictors of postoperative stone clearance and 12-month recurrence in patients with HSK and PEK undergoing endourological procedures intervention.Methods: We conducted a retrospective analysis of 50 consecutive patients with CT-confirmed HSK or PEK treated with retrograde intrarenal surgery (RIRS) or mini-percutaneous nephrolithotomy (mini-PNL) over 12 months. All patients had a standardized 24-hour metabolic evaluation and imaging followup at 1, 6, and 12 months. Outcomes included stone-free status at one month and recurrence at one year. Predictors were assessed using univariable and multivariable logistic regression.Results: Stone-free status at 1 month was achieved in 62% of patients, with 22% having residual fragments \u22654 mm. Residual burden was strongly associated with recurrence, which occurred in 44% of the cohort. Patients with fragments \u22654 mm had the highest recurrence rate (72.7%), compared with 35.5% among stone-free individuals (p=0.047). Age was independently associated with reduced likelihood of achieving stone-free status (B = -0.069, p=0.011). Higher 24-hour urinary volume was the only biochemical parameter protective against recurrence (OR 0.243, p=0.039). Neither malformation type nor surgical technique significantly influenced postoperative outcomes or recurrence. Metabolic abnormalities were frequent but not predictive of stone type or recurrence.Conclusions: In HSK and PEK, postoperative residual fragments and low urine volume are the main determinants of recurrence, whereas anatomical subtype and surgical approach have limited prognostic value. Strategies focused on complete stone clearance and hydration optimization may improve long-term outcomes in this patient population.<\/jats:p>","DOI":"10.4081\/aiua.2026.14702","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:01:13Z","timestamp":1771632073000},"source":"Crossref","is-referenced-by-count":0,"title":["Metabolic and surgical predictors in horseshoe and pelvic ectopic kidneys"],"prefix":"10.4081","volume":"98","author":[{"given":"\u0218tefan","family":"Ra\u0219cu","sequence":"first","affiliation":[{"name":"Department of Urology, \u201cProf. Dr. Theodor Burghele\u201d Clinical Hospital, Bucharest"},{"name":"Carol Davila University of Medicine and Pharmacy, Bucharest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ovidiu Catalin","family":"Nechita","sequence":"additional","affiliation":[{"name":"Department of Urology, \u201cProf. Dr. Theodor Burghele\u201d Clinical Hospital, Bucharest"},{"name":"Carol Davila University of Medicine and Pharmacy, Bucharest,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tudor Marian","family":"Proca","sequence":"additional","affiliation":[{"name":"Department of Urology, \u201cProf. Dr. Theodor Burghele\u201d Clinical Hospital, Bucharest"},{"name":"Carol Davila University of Medicine and Pharmacy, Bucharest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Liviu","family":"Badescu","sequence":"additional","affiliation":[{"name":"Department of Urology, \u201cProf. Dr. Theodor Burghele\u201d Clinical Hospital, Bucharest"},{"name":"Carol Davila University of Medicine and Pharmacy, Bucharest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George-Sabin","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Urology, \u201cProf. Dr. Theodor Burghele\u201d Clinical Hospital, Bucharest"},{"name":"Carol Davila University of Medicine and Pharmacy, Bucharest"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viorel","family":"Jinga","sequence":"additional","affiliation":[{"name":"Department of Urology, \u201cProf. Dr. Theodor Burghele\u201d Clinical Hospital, Bucharest"},{"name":"Carol Davila University of Medicine and Pharmacy, Bucharest"},{"name":"Romanian Academy of Scientists, Bucharest"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"214775","unstructured":"1. Evans WP, Resnick MI. Horseshoe kidney and urologic anomalies. Urol Clin North Am 1978; 5:75-88."},{"key":"214776","unstructured":"2. Yoon Y, Lee YJ, Jung H, et al. The surgical outcome of ureteroscopy for nephrolithiasis in pelvic kidneys. Investig Clin Urol 2020; 61:379-84."},{"key":"214777","unstructured":"3. Gupta M, Cha K. Stones in exceptional situations: management of stones in patients with renal anomalies. Asian J Urol 2013; 1:10-7."},{"key":"214778","unstructured":"4. Legemate JD, Zanetti SP, Giusti G, et al. Ureteroscopic treatment of renal stones in anomalous kidneys: results from the CROES URS global study. J Urol 2017; 198:43-9."},{"key":"214779","unstructured":"5. Ozmerdiven G, Akca O, Sancaktutar AA, et al. Outcomes of retrograde intrarenal surgery in anomalous kidneys: predictors of success and complications. World J Urol 2023; 41:453-9."},{"key":"214780","unstructured":"6. Lim EJ, Mahapatra R, Shah A, et al. Outcomes of RIRS and PCNL in horseshoe and ectopic kidneys: a multicenter study. J Endourol 2022; 36:1151-8."},{"key":"214781","unstructured":"7. Eryildirim B, Tuncer M, Sahin C, et al. Retrograde intrarenal surgery versus percutaneous nephrolithotomy in horseshoe kidneys: a comparative study. Turk J Urol 2018; 44:105-9."},{"key":"214782","unstructured":"8. Kartal I, Sofikerim M, Demirci D, et al. Outcomes of PCNL in patients with horseshoe kidneys. Urolithiasis 2019; 47:259-65."},{"key":"214783","unstructured":"9. Senocak C, Ozden E, Demir A, et al. Percutaneous nephrolithotomy in horseshoe kidneys: does it differ from normal anatomy? Urol Res 2019; 47:493-8."},{"key":"214784","unstructured":"10. Karaolides T, Bach C, Kachrilas S, et al. The efficacy and safety of PCNL in horseshoe kidneys: a matched case-control study. J Endourol 2011; 25:949-53."},{"key":"214785","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2016.05.091"},{"key":"214786","unstructured":"12. Borghi L, Meschi T, Amato F, et al. Urine volume: a key factor in stone disease prevention. 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