Complications
Although previously considered a mere nuisance infection, untreated bacterial vaginosis may cause increased susceptibility to sexually transmitted infections, including HIV, and pregnancy complications.It has been shown that HIV-infected women with bacterial vaginosis (BV) are more likely to transmit HIV to their sexual partners than those without BV. There is evidence of an association between BV and increased rates of sexually transmitted infections such as HIV/AIDS. BV is associated with up to a six-fold increase in HIV shedding. BV is a risk factor for viral shedding and herpes simplex virus type 2 infection. BV may increase the risk of infection with or reactivation of human papillomavirus (HPV).In addition, bacterial vaginosis as either pre-existing, or acquired, may increase the risk of pregnancy complications, most notably premature birth or miscarriage. Pregnant women with BV have a higher risk of chorioamnionitis, miscarriage, preterm birth, premature rupture of membranes, and postpartum endometritis. Women with BV who are treated with in vitro fertilization have a lower implantation rate and higher rates of early pregnancy loss. Causes
Healthy vaginal microbiota consists of species that neither cause symptoms or infections, nor negatively affect pregnancy. It is dominated mainly by Lactobacillus species. BV is defined by the disequilibrium in the vaginal microbiota, with decline in the number of lactobacilli.
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


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