Heminephrectomy

Overview

Heminephrectomy is a surgical intervention aimed at removing a dysfunctional portion of a kidney, often undertaken in cases of duplex kidney. This procedure aims to enhance the functionality of the remaining healthy segment of the kidney. Duplex kidney is a condition characterized by the presence of two ureters in one or both kidneys, instead of the usual single ureter. Ureters are the tubes responsible for transporting urine from the kidneys to the bladder. In a duplex kidney, these two ureters may either enter the bladder separately or merge together before reaching the bladder.

Reasons for undergoing the procedure

A heminephrectomy is typically performed to treat several conditions, such as:

  • Severe kidney injuries due to accidents
  • Kidney affected by cancer
  • Duplex kidney

Removing the damaged portion of a kidney frequently restores proper function to the remaining part.

A heminephrectomy, or partial removal of one kidney, is a treatment option for duplex kidney. While having a duplex kidney may not always present symptoms, it can lead to issues like vesicoureteral reflux. Other complications may also arise if one ureter drains improperly or forms a ureterocele at its entry into the bladder. Those with duplex kidneys may experience frequent bladder or urinary tract infections, resulting in painful urination or urgency.

Signs indicating potential kidney issues include observing blood in the urine, experiencing lower back pain, having a reduced appetite, or detecting a lump near the stomach area.

Other treatment options for duplex kidney include using antibiotics to prevent infections and surgical repair of the affected ureter. The choice of treatment depends on factors such as kidney function and specific complications.

Risk

Although uncommon, potential complications with heminephrectomy include:

  • Infection
  • Damage to nearby organs like the bowels, liver, or spleen
  • Bleeding

Procedure

Prior to surgery, various diagnostic tests like ultrasound, blood tests, MRI, and CT scans are conducted to confirm kidney issues warranting heminephrectomy. In some instances, dye may be injected into the bladder during diagnostic procedures to trace its passage through the ureters toward the kidney.

Minimally invasive techniques, such as laparoscopic surgery, are often employed to address kidney problems, offering faster recovery times compared to traditional open surgery. Following catheter removal, most patients can be discharged from the hospital.

The procedure may include:

  • Administering general anesthesia to remain unconscious during the procedure
  • Making a small incision through which surgical instruments and a camera (laparoscope) are inserted
  • Placing a catheter in the bladder to assist with urination immediately after surgery and for the initial recovery period

During recovery, avoiding strenuous activities and following a special diet may be advised.

Outcome

People who have only one fully functional kidney may face an increased risk of developing high blood pressure. Regular urine and blood tests are usually advised to monitor kidney function and ensure effective removal of toxins from the bloodstream.

Living with one kidney or a partial kidney is generally manageable and conducive to a healthy life. Even after partial removal, the remaining kidney tissue can sufficiently perform essential functions.