Pelvicalcyeal System Morphology and Variations among Sudanese Subjects

Abstract

Background: The Pelvicalcyeal system of the kidney is a common site for congenital anomalies and variations. Understanding the three-dimensional orientation of renal calyces and their relationship to the frontal plane is critical for endourological procedures and the interpretation of imaging studies. This study aims to measure the upper, middle, and lower infundibular lengths and widths, as well as the infundibulo-pelvic angle (IFPA), classify the renal pelvis and collecting system, and explore the relationships between the lower infundibulum parameters (IFPA, Length of Lower Infundibulum (LIL), and Width of Lower Infundibulum (LIW)) and other parameters such as the type of collecting system, type of renal pelvis, laterality, and data source. Additionally, the study seeks to identify Pelvicalcyeal congenital anomalies and the presence of staghorn stones.

Patients and Methods: Samples for this study were from two sources: cadaveric kidney dissection, using rulers and metered tape for pelvic type identification, congenital anomalies, and staghorn stone assessment, as well as CT scan urography analyzed using the “Radi-ant Dicom” software tool.

Results: The results indicate that the longest infundibulum was the upper one, with the lower infundibulum being the widest. The IFPA measured greater than 90 degrees in 65% of the samples. The most frequent classifications identified were Type A1 and tricalyceal pelvicalyceal systems, along with the brachy type pelvis. Congenital anomalies were observed in 11% of cases, and staghorn stones were present in 5%. Notably, the IFPA was more acute in the left kidneys, widest in Simpson’s Type A11, tricalyceal systems, and in brachy (short) pelvises. While these findings were statistically non-significant, significant differences were noted in cadaveric samples compared to CT findings. The lower infundibulum was longer in right kidneys (non-significant) and wider in left kidneys (non-significant).

Conclusion: The anatomy of the pelvicalyceal system in the Sudanese population aligns with global norms, while variability exists even among individuals within the same population.