Long-term outcome of laparoscopic retroperitoneal nephropexy.

BACKGROUND AND PURPOSE: Laparoscopy has been reported recently as a minimally invasive approach for nephropexy. We evaluated our long-term outcomes and quality of life (QoL) after laparoscopic retroperitoneal nephropexy (LRNP).

PATIENTS AND METHODS: Forty-eight patients with symptomatic nephroptosis with a mean age of 36.2 years underwent LRNP between February 1993 and October 2004 in two German centers. Preoperatively, intravenous urography (IVU) and a renal scan were performed in supine and upright positions. Postoperatively, the IVU and renal scan were repeated. The patients were asked after a median follow-up of 8.16 years for long-term postoperative outcome with a mailed questionnaire about their QoL, symptoms, and whether they would undergo the operation again.

RESULTS: No major intraoperative complications were observed. The mean operative time was 95 minutes (range 50-200 min). The median blood loss was less than 50 mL. Postoperatively, 94.1% of the kidneys radiographically showed no ptosis or ptosis less than one vertebral body. We were able to contact 41 of 48 (85.4%) patients, of whom 95% had no objective symptoms after the operation and 91% had an improvement of their pain symptoms. Of the contacted patients, 70.7% reported an improvement in their QoL and 87% would undergo the operation again.

CONCLUSION: LRNP is a minimally invasive, suitable, established method for managing symptomatic nephroptosis with good long-term clinical outcomes and patient satisfaction. This approach also improves patients' perceived QoL.