Recently, our Urology, working together with Endocrinology and Ultrasonic Medicine, dealt with a rare case of reninoma. The surgery turned out hugely successful thanks to clear diagnosis, full assessment of risks, full preparations and great skills of the team.

Two years ago, Xiao Mei (alias), who was 19-week pregnant, suddenly had hypertension and edema. She thought it was only the pregnancy but in only two days she gained 6kg due to the edema and the sudden rise of intraocular pressure led to blurred vision, leaving her unable to work. The test result was shocking, her blood pressure was 220mmHg-180mmHg, and the pregnancy must be terminated. In the following two years she went to many doctors and the result was always primary hypertension and hypokalemia. No matter what treatment she received, the hypertension refused to go.

Exhausted, Xiao Mei finally was at PUMCH, hoping for an answer. A joint diagnosis from Urology and Endocrinology was reninoma in the left kidney, and an elective surgery after assessment was recommended. The condition was so rare that there were only around a hundred previous cases across the country. Her doctor searched documents and told her about the disease to help erase her uneasiness.

The reninoma turned out deep inside the kidney, giving difficulty not only to diagnosis but location and removal. The team decided on laparoscopy. Urology and Ultrasonic Medicine worked closely to locate the focus at the fastest speed. According to Surgeon Fan Hua, Professor Zhang Yushi, who was in charge, only took 19 minutes to block the renal artery and smoothly removed the reninoma, 1cm in diameter. After the procedure the patient showed a serum creatinine level similar with that before the surgery and drainage was small, showing that her kidney functions were best protected.

After the surgery, all her tormenting symptoms-hypertension, all-over edema, fatigue and palpitation-disappeared. Now she can live a normal life and can even get pregnant again and become a mother.

      Laparoscopic surgery