Urinary schistosomiasis: Urographic features and significance of drooping kidney appearance

The purpose of the study was to analyse the urographic features of schistosomiasis and to see the therapeutic implications of "drooping kidney" appearance for the urologists. Over a period of one year, 1636 patients undergoing intravenous urography (IVU) were analysed to look for urographic features of schistosomiasis. A total of 136 patients revealed the classical urographic feature such as ureteric strictures, vesical and ureteric calcification and calculi etc. 131 of these patients were of Egyptian origin. In addition to above mentioned classical features, 8 patients (6%) with urinary schistosomiasis revealed "drooping kidney" appearance. In the remaining patients with no evidence of clinical or urographic features of urinary schistosomiasis, only one patient (0.07%) showed similar bilateral appearance. Renogram in 6 to 8 patients with "drooping kidney" revealed poorer renal function on the affected side. Ureteroscopy (URS) revealed more florid ureteritis cystica on the side with "drooping kidney" in 6 out of 8 patients compared with the normal side. URS also confirmed the presence of a kink and more difficulty with insertion of J stents. "Drooping kidney" a new urographic feature of urinary schistosomiasis may have therapeutic implications for the urologists and should be looked for on the I.V.U. of patients with urinary schistosomiasis.