Aim: To present a very rare case of bilaterally-complicated horseshoe kidney by nephrolithiasis in a patient with situsinversus with levocardia and skeletal anomalies. Case Report: A 41-year-old female presented by right loin pain. Abdominal ultrasound showed bilateral kidney stones with malrotation, right mild hydronephrosis and transposition of the abdominal organs. Chest X-ray showed the heart normal in the left side. Also, computed tomography revealed a horseshoe kidney with bilateral stones. After counseling the patient about the stones treatment options, she preferred extracorporeal shock-wave lithotripsy which was tried on the right side firstly, but it failed. So, percutaneous nephrolithotripsy was scheduled. Discussion: Situs inversus is a spectrum of congenital anomalies. Situsinversus totalis is the commonest variety and was reported with renal congenital anomalies like horseshoe kidney, acquired renal diseases like renal cell carcinoma, and in living kidney donation. However, situs inversus with levocardia is a rare variety with a known association to the congenital heart defects. Its association to a complicated horseshoe kidney and scoliosis could not be found in the English literature before the current case. Moreover, absence of congenital heart defects is extremely rare. Conclusion: Association of situs inversus with levocardia to skeletal anomalies and complicated horseshoe kidney is a unique situation. It indicates meticulous evaluation and management.

Aim: Presentation of an abdominoscrotal hydrocele case with a very rare association to multiple anomalies and separate abdominal and inguinoscrotal sacs. Case Report: A 21-year-old male patient presented with left-sided abdominoscrotal hydrocele, impalpable right testis, hydrocephalus and cerebral and musculoskeletal deformities. On abdominal ultrasonography, the abdominal and inguinoscrotal components were seen separated by a septum that was confirmed on surgery. Extended inguinal incision was used for repair and the post-operative course was uneventful. Discussion: Abdominoscrotal hydrocele is a rare entity and its simultaneous association to multiple anomalies, like in the current case, is a rarer finding. Non-intercommunication state is another very rare criteria of abdominoscrotal hydrocele which was clinically, sonographically and surgically demonstrated in this case. Extended inguinal incision was indicated and enough to deal with both abdominal and scrotal components. Conclusion: Abdominoscrotal hydrocele is mostly intercommunicating, but it is exceptionally non-intercommunicating and associated to multiple anomalies. Surgical excision via an extended inguinal incision may be indicated for voluminous cases and those with a solitary testis.

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Introduction: Preemptive (P) living donor kidney transplantation (LDKT) provides better survival rates, quality of life and economic saving. However, the extent of these advantages over those with a short period of pre-LDKT dialysis is not known. Objectives: Evaluation of the patients’ characteristics and short-term outcomes of PLDKT and LDKT after a pre-transplant period of hemodialysis (HD) not >6 months. Patient and methods: This study was conducted between June 2010 and June 2012 and included two groups. Group-I included recipients without HD before operation. Group-II included those who had a period of HD ≤6 months. Recipients and donors were evaluated according to the classic work up. Follow-up for 12 months was scheduled. Results: Group-I included 30 recipients and group-II included 15 recipients. Demographic and clinical characteristics were similar except for mean recipient age (44 versus 34.3 years; p = 0.024), recipient donor age difference (p = 0.03), job categories (p = 0.047) and ABO distribution (p = 0.01). Cumulative graft (0.88 versus 0.93) and recipient (0.92 versus 0.100) survival rates were non-significantly different. Graft function and mean serum creatinine level were within normal up to 12 months. Acute graft rejection (AGR) was significantly higher in group-II (16.7% versus 46.7%; p = 0.03). However, lymphoceles were significantly more common in group-I (40% versus 6.7%; p = 0.02). There was no delayed graft function (DGF), major urinary or vascular complications. Conclusion: PLDKT has a lower rate of AGR. Despite it has a higher rate of lymphoceles, it saves the patient the morbidities of vascular access and inconveniences of HD. Hence, PLDKT is recommended as the first choice for each KT-candidate.

Introduction: Preemptive (P) living donor kidney transplantation (LDKT) provides better survival rates, quality of life and economic saving. However, the extent of these advantages over those with a short period of pre-LDKT dialysis is not known. Objectives: Evaluation of the patients’ characteristics and short-term outcomes of PLDKT and LDKT after a pre-transplant period of hemodialysis (HD) not >6 months. Patient and methods: This study was conducted between June 2010 and June 2012 and included two groups. Group-I included recipients without HD before operation. Group-II included those who had a period of HD ≤6 months. Recipients and donors were evaluated according to the classic work up. Follow-up for 12 months was scheduled. Results: Group-I included 30 recipients and group-II included 15 recipients. Demographic and clinical characteristics were similar except for mean recipient age (44 versus 34.3 years; p = 0.024), recipient donor age difference (p = 0.03), job categories (p = 0.047) and ABO distribution (p = 0.01). Cumulative graft (0.88 versus 0.93) and recipient (0.92 versus 0.100) survival rates were non-significantly different. Graft function and mean serum creatinine level were within normal up to 12 months. Acute graft rejection (AGR) was significantly higher in group-II (16.7% versus 46.7%; p = 0.03). However, lymphoceles were significantly more common in group-I (40% versus 6.7%; p = 0.02). There was no delayed graft function (DGF), major urinary or vascular complications. Conclusion: PLDKT has a lower rate of AGR. Despite it has a higher rate of lymphoceles, it saves the patient the morbidities of vascular access and inconveniences of HD. Hence, PLDKT is recommended as the first choice for each KT-candidate.

Introduction: Preemptive (P) living donor kidney transplantation (LDKT) provides better survival rates, quality of life and economic saving. However, the extent of these advantages over those with a short period of pre-LDKT dialysis is not known. Objectives: Evaluation of the patients’ characteristics and short-term outcomes of PLDKT and LDKT after a pre-transplant period of hemodialysis (HD) not >6 months. Patient and methods: This study was conducted between June 2010 and June 2012 and included two groups. Group-I included recipients without HD before operation. Group-II included those who had a period of HD ≤6 months. Recipients and donors were evaluated according to the classic work up. Follow-up for 12 months was scheduled. Results: Group-I included 30 recipients and group-II included 15 recipients. Demographic and clinical characteristics were similar except for mean recipient age (44 versus 34.3 years; p = 0.024), recipient donor age difference (p = 0.03), job categories (p = 0.047) and ABO distribution (p = 0.01). Cumulative graft (0.88 versus 0.93) and recipient (0.92 versus 0.100) survival rates were non-significantly different. Graft function and mean serum creatinine level were within normal up to 12 months. Acute graft rejection (AGR) was significantly higher in group-II (16.7% versus 46.7%; p = 0.03). However, lymphoceles were significantly more common in group-I (40% versus 6.7%; p = 0.02). There was no delayed graft function (DGF), major urinary or vascular complications. Conclusion: PLDKT has a lower rate of AGR. Despite it has a higher rate of lymphoceles, it saves the patient the morbidities of vascular access and inconveniences of HD. Hence, PLDKT is recommended as the first choice for each KT-candidate.

Introduction: Preemptive (P) living donor kidney transplantation (LDKT) provides better survival rates, quality of life and economic saving. However, the extent of these advantages over those with a short period of pre-LDKT dialysis is not known. Objectives: Evaluation of the patients’ characteristics and short-term outcomes of PLDKT and LDKT after a pre-transplant period of hemodialysis (HD) not >6 months. Patient and methods: This study was conducted between June 2010 and June 2012 and included two groups. Group-I included recipients without HD before operation. Group-II included those who had a period of HD ≤6 months. Recipients and donors were evaluated according to the classic work up. Follow-up for 12 months was scheduled. Results: Group-I included 30 recipients and group-II included 15 recipients. Demographic and clinical characteristics were similar except for mean recipient age (44 versus 34.3 years; p = 0.024), recipient donor age difference (p = 0.03), job categories (p = 0.047) and ABO distribution (p = 0.01). Cumulative graft (0.88 versus 0.93) and recipient (0.92 versus 0.100) survival rates were non-significantly different. Graft function and mean serum creatinine level were within normal up to 12 months. Acute graft rejection (AGR) was significantly higher in group-II (16.7% versus 46.7%; p = 0.03). However, lymphoceles were significantly more common in group-I (40% versus 6.7%; p = 0.02). There was no delayed graft function (DGF), major urinary or vascular complications. Conclusion: PLDKT has a lower rate of AGR. Despite it has a higher rate of lymphoceles, it saves the patient the morbidities of vascular access and inconveniences of HD. Hence, PLDKT is recommended as the first choice for each KT-candidate.