What is the risk for ectopic insertion of the distal ureter into the bladder in a horseshoe kidney?
No greater than the normal population.
How can stones in a horseshoe kidney be treated?
Similarly to stone disease in normal kidneys. Extracorporeal shock wave lithotripsy (ESWL) has been used, with retrograde intrarenal surgery with flexible ureterorenoscopy (URS) considered for non-responders. Open surgery is not usually necessary.
Are horseshoe kidneys at increased risk for developing renal cell carcinoma (RCC)?
No.... but they are at increased risk for developing Wilms tumor.
Horseshoe kidney with a 6 mm stone at the right ureterovesical junction (UVJ). There is dilatation of the upstream collection system with stranding and a small amount of free fluid anterior to the right renal pelvis and proximal ureter, compatible with rupture and urine leak into the peritoneal space.
The left-sided collecting system is not dilated.
The appendix is normal.