Retropelvic artery: anatomical background for experimental urology (Review article)

Introduction: transoperative and postoperative bleeding still are important complications in urologic procedures at the upper pole. A detailed review of the retropelvic artery anatomy would be helpful to surgeons. The aim of the present study was to revisit the anatomy of the retropelvic artery and its importance for urology, as well as evaluate the presence and morphology of this artery in animal models. The posterior division of the renal artery (retropelvic artery) describes an arch close to the upper infundibulum (57%) or crosses the posterior aspect of the renal pelvis (43%). Simulated partial nephrectomy of the upper pole shows that partial nephrectomies performed at less than 1.0 cm of the hilar superior margin impair the retropelvic artery. When the retropelvic artery is damaged, it could cause destruction of a large area of the remaining renal posterior parenchyma, sometimes leading to postoperative leak. Although retropelvic artery is not present in any animal model on the same way as in humans, when simulated partial nephrectomy is performed in the cranial pole of pig kidneys, the outcomes are quite similar to the same procedure carried out in humans. So, even though the retropelvic artery was not demonstrated in any animal model, it is not possible to state that sections of the cranial pole in those animals would injury important arteries for the kidney parenchyma, as in humans and pigs.