An ectopic kidney is a congenital anomaly where one or both kidneys are not located in their usual position in the abdomen. Instead, the kidney may be found in the pelvis, lower abdomen, or even on the opposite side of the body. Though some children with ectopic kidneys remain asymptomatic, others may experience urinary tract obstruction, hydronephrosis, recurrent urinary tract infections (UTIs), or bedwetting.
Early diagnosis and expert monitoring by a pediatric urologist are essential to prevent long-term damage to kidney function. For children in Central India, Dr. Sadashiv Bhole, a renowned pediatric urologist and urology surgeon in Nagpur, offers specialized evaluation and care for kidney position anomalies like ectopic kidneys.
What is an Ectopic Kidney?
- An ectopic kidney is one that has failed to ascend to its normal position during fetal development
- The kidney may be:
- Pelvic (most common) – located near the bladder
- Thoracic (rare) – located in the chest
- Crossed fused ectopia – both kidneys on the same side, fused together
- Occurs in about 1 in 900 births, with pelvic kidney being the most frequently observed variant
Causes and Development
- Occurs during the 6th to 9th week of gestation, when kidneys fail to migrate to the upper abdomen
- May be associated with:
- Urinary tract malformations
- Ureteropelvic junction obstruction (UPJO)
- Vesicoureteral reflux (VUR)
- Other anomalies of the spine or reproductive organs
- Usually not inherited, but syndromic associations may be present in rare cases
Symptoms of Ectopic Kidney in Children
Many children remain asymptomatic and the condition is discovered during evaluation for other issues. However, signs and symptoms may include:
- Recurrent urinary tract infections (pediatric UTI)
- Painful urination (dysuria)
- Bedwetting (nocturnal enuresis) or daytime wetting
- Abdominal or pelvic pain
- Foul-smelling urine
- Urinary incontinence or dribbling
- Hydronephrosis (swelling of the kidney due to urine buildup)
- Palpable abdominal mass in some cases
Associated Complications
If not properly monitored, an ectopic kidney may lead to:
- Reduced kidney function
- Urinary tract obstruction
- Stones in the kidney or bladder
- Pediatric nephrolithiasis (kidney stones in children)
- Chronic kidney disease in long-standing obstruction cases
- Reflux nephropathy if associated with VUR
How Is It Diagnosed?
Diagnosis is typically made using a combination of imaging and functional studies:
- Ultrasound of abdomen and pelvis – to locate and visualize the kidney
- Renal scan (DTPA or MAG3) – to assess function and drainage
- Voiding cystourethrogram (VCUG) – to detect vesicoureteral reflux
- MRI or CT scan – for detailed anatomical assessment in complex cases
Many cases are detected incidentally during evaluation of recurrent UTIs, bedwetting, or daytime wetting.
Treatment and Management
Observation
- If the kidney is functioning normally and there are no complications, no surgery is required
- Child is monitored regularly with renal scans, urine tests, and blood pressure checks
Surgical Intervention
- Surgery is needed if there are associated problems such as:
- Ureteropelvic junction obstruction
- Reflux (VUR) causing recurrent infections
- Hydronephrosis or impaired drainage
- Stones or urinary obstruction
Common procedures may include:
- Pyeloplasty for UPJ obstruction
- Ureteral reimplantation for reflux
- Stone removal in nephrolithiasis
- Minimally invasive and robot-assisted surgeries are preferred today for faster recovery and precision
Long-Term Outlook
- Children with a solitary ectopic kidney (and normal opposite kidney) often lead a normal life
- Regular follow-up with pediatric urology or nephrology is vital to ensure:
- Healthy growth of the kidney
- Maintenance of blood pressure
- Absence of recurrent infections
- Lifestyle counseling includes adequate hydration, avoiding unnecessary medications, and preventing trauma to the lower abdomen
An ectopic kidney may not always cause symptoms but must be closely monitored to avoid complications. If your child has recurrent UTIs, bedwetting, daytime wetting, or urinary obstruction, a detailed evaluation is essential.
Book a consultation with Dr. Sadashiv Bhole, a trusted pediatric urologist in Nagpur, for comprehensive diagnosis and management of congenital kidney conditions.
