Study of the lower renal cup anatomy using multispiral computed tomography in relation to the problems of ureterocalicostomy




ureterocalicostomy, anatomy of the lower renal cup


The possibilities for performing ureterocalicostomy significantly depend on the anatomy of the lower group of cups, which has not been examined yet from the point of view of this operation. The study included 115 patients who underwent multispiral computed tomography for various indications. The number of small cups of the lower group ranged from 1 to 5 (2.5 on average). We identified four main options for localizing renal cups in the region of the lower pole: I – one of the cups is localized in front, and the second along the vertical axis of the kidney (n = 13 / 11.3%); II – one of the cups is localized in front, and the second in the back (n = 35 / 30.4%); III – there is only one cup suitable for ureterocalicostomy, located along the vertical axis of the kidney (n = 18 / 15.7%); IV – one of the cups is localized at the back, and the second along the vertical axis of the kidney (n = 49 / 42.6%). The probability of damage to two cups with transverse resection of the kidney is 29.6%, while with oblique resection of kidney it is 12.2%. Information about the number of renal cups in the lower group and their spatial localization plays an important role in planning ureterocalicostomy. The proposed anatomical classification of cup anatomy allows choosing the type of renal resection in a particular patient and avoiding damage to adjacent cup structures.


Casale P., Mucksavage P., Resnick M., Kim S. Robotic Ureterocalicostomy in the pediatric population. J Urol. 2008. Vol. 180. P. 2643–2648.

Osman T., Eltahawy I., Fawaz Kh. et al. Ureterocalicostomy for treatment of complex cases of ureteropelvic junction obstruction in adults. Urology. 2011. Vol. 78. P. 202–207.

Arap M.A., Andrade H., Torricelli F.C., Denes F.T., Mitre A.I., Duarte R.J., Srougi M. Laparoscopic ureterocalicostomy for complicated upper urinary tract obstruction: mid-term follow-up. Int Urol Nephrol. 2014. Vol. 46(5). P. 865–869.

Комяков Б.К., Гулиев Б.Г., Аль Аттар Т.Х. Лапароскопічний уретерокалікоанастомоз при протяжній рецидивній стриктурі пиелоуретерального сегмента справа. Вісник урології Urology Herald. 2017. Vol. 5(3). P. 87–94.

Srivastava D., Sureka S.K., Yadav P., Bansal A., Gupta S., Kapoor R., Ansari M.S., Srivastava A. Ureterocalicostomy for Reconstruction of Complicated Ureteropelvic Junction Obstruction in Adults : Long-Term Outcome and Factors Predicting Failure in a Contemporary Cohort. J Urol. 2017. Vol. 198(6). P. 1374–1378.

Neuwirt K. Implantation of the lower ureter into the lower calyx of the renal pelvis. VII Congress de le Societe Internationale d’Urologie. 1947. P. 253–255.

Hawthorne N.J., Zincke H., Kelalis P.P. Ureterocalicostomy: an alternative to nephrectomy. J. Urol. 1976. Vol. 115, No. 5. P. 583–586.

Brodel M. The intrinsic blood-vessels of the kidney and their significance in nephrotomy. Bull Johns Hopkins Hosp. 1901. Vol. 12. P. 10.

Hodson J. The lobar structure of the kidney. Br J Urol. 1972. Vol. 44. P. 246.

Kaye K.W., Reinke D.B. Detailed caliceal anatomy for endourology. J Urol. 1984. Vol. 32. P. 1085.

Miller J., Durack J.C., Sorensen M.D., Wang J.H., Stoller M.L. Renal calyceal anatomy characterization with 3-dimensional in vivo computerized tomography imaging. J Urol. 2013. Vol. 189(2). P. 562–567.