Abstract
BACKGROUND: Ectopic kidney is a rare congenital anomaly characterized by abnormal renal ascent and frequent structural variants that predispose to urologic complications. This study aimed to investigate the clinical features, anatomical variations, and treatment strategies in patients with ectopic kidneys to inform individualized management. METHODS: This single-center retrospective cohort included 95 patients (100 ectopic kidneys). Clinical data, including imaging findings, complications and treatment modalities, were collected. Anatomical characteristics, such as the location, rotation, and vascular variations of the ectopic kidneys, were evaluated through imaging. Surgical interventions were performed for urolithiasis, hydronephrosis and renal tumor patients. RESULTS: The median diagnostic age was 37.0 years [interquartile range (IQR), 22.5-57.0 years], with 51/95 (53.7%) patients male and 44/95 (46.3%) female. Among the 100 ectopic kidneys, 63 (63.0%) were located in the pelvis, 24 (24.0 %) in the iliac fossa and 13 (13.0%) in the abdomen. Malrotation was observed in 55 of the 60 ectopic kidneys evaluated (91.7%). Vascular variations, including multiple vessels and anomalous origins, were common. Sixty patients (63.2%) were asymptomatic, whereas 14 (14.7%) reported abdominal or lumbar pain and 6 (6.3%) presented with hematuria. Urolithiasis affected 12 kidneys (12.0%), hydronephrosis occurred in 15 (15.0%), and renal tumors were present in 6 cases (6.0%). Twenty-six patients underwent surgery: 9 (34.6%) received transurethral endoscopic procedures, 8 (30.8%) underwent open surgery and 9 (34.6%) had laparoscopic surgery. CONCLUSIONS: Ectopic kidneys are frequently associated with structural abnormalities, such as malrotation and vascular variations, and are predisposed to complications, including urolithiasis and hydronephrosis. Early diagnosis, individualized treatment, and lifelong follow-up are essential for improving patient outcomes.