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    Laparoscopic renal denervation for loin pain haematuria syndrome

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    2 The condition, current treatments and procedure

    The condition

    2.1 Loin pain haematuria syndrome (LPHS) causes severe, recurrent flank pain and haematuria (either macroscopic or microscopic). The cause of LPHS is unknown and diagnosis is only made after excluding all other possible renal causes of flank pain and haematuria.

    Current treatments

    2.2 Initial treatment of LPHS involves prescription of analgesics, up to and including opioids. If these are unsuccessful, surgical intervention can be tried, including renal denervation, nephrectomy, and renal autotransplantation.

    The procedure

    2.3 Laparoscopic renal denervation is a minimally invasive procedure to interrupt the sensorial and sympathetic innervation of the kidney to control the pain. The procedure is done under general anaesthesia, using a retroperitoneal approach. Lymphatic and nervous tissue are stripped off the renal artery and vein with subsequent division of all perihilar nervous tissue, with or without mobilisation of the kidney. The laparoscopic technique aims to reduce the anaesthetic time and produce a quicker recovery time than open surgery.