2 The condition, current treatments and procedure
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.
2.2 Initial treatment of LPHS involves prescription of analgesics, up to and including opioids. Other treatments include transcutaneous electrical nerve stimulation, regional nerve blocks and radiofrequency ablation. If these are unsuccessful, surgical intervention can be tried, including open surgical renal denervation, capsulotomy (often done in conjunction with open surgical renal denervation), nephrectomy, and renal autotransplantation.
2.3 Laparoscopic renal denervation is a minimally invasive procedure to interrupt the sensorial and sympathetic innervation of the kidney to control pain. The procedure is done under general anaesthesia, using a retroperitoneal approach. Lymphatic and nervous tissue is stripped off the renal artery and vein with subsequent division of all perihilar nervous tissue, with or without mobilisation of the kidney. Laparoscopic renal denervation does not include capsulotomy, which may be included in open surgical renal denervation.
2.4 The laparoscopic technique aims to reduce the anaesthetic time and produce a quicker recovery time than open surgery.