For this reason, prior to any treatment with shockwave lithotripsy, a UPJ obstruction must first be ruled out as it significantly impair successful treatment. For stones that are less than 1.5 cm, ureteroscopy and shockwave lithotripsy can be first utilized. For stones larger than 1.5 cm or when previous treatment has failed, the stones can instead be removed through a minimally invasive procedure known as percutaneous nephrolithotomy.Compared to patients with normal kidneys, patients with horseshoe kidneys who undergo treatment with percutaneous nephrolithotomy experience no difference in complications or stone clearance.Patients will also typically require imaging before any abdominal surgery as the vascular supply to the abnormal kidney can be highly variable between patients. Additionally, the horseshoe kidneys can have a close association with colon which can increase risk of bowel injury. Epidemiology
There is an incidence of 1 in every 500 individuals within a normal population.Males are more likely to develop a horseshoe kidney with a preponderance of 2:1.Certain genetic diseases can predispose patients to developing a horseshoe kidney:

Edwards Syndrome: 67%
Turner Syndrome: 14-20%
Down Syndrome: <1%

Notable cases
Mel Gibson is affected with this condition. Sam Kinison, an American comedian, also had this condition. Robert Rowan a member of the Anglican clergy was afflicted by the condition. References


== External links ==
Inguinal lymphadenopathy causes swollen lymph nodes in the groin area. It can be a symptom of infective or neoplastic processes. Infective aetiologies include Tuberculosis, HIV, non-specific or reactive lymphadenopathy to recent lower limb infection or groin infections. Another notable infectious cause is Lymphogranuloma venereum, which is a sexually transmitted infection of the lymphatic system. Neoplastic aetiologies include lymphoma, leukaemia and metastatic disease from primary tumours in the lower limb, external genitalia or perianal region and melanoma. References
Ferrer R (October 1998). "Lymphadenopathy: differential diagnosis and evaluation". Am Fam Physician. 58 (6): 1313–20. PMID 9803196. Further reading
Principles and Practice of Infectious Diseases. Elsevier Health Sciences. 2014. ISBN 9781455748013. Retrieved 21 December 2017.