Objectives. The differential diagnosis of renal pain is extensive. When the pain is altered by a change in position, two relatively uncommon etiologies, nephroptosis and ovarian vein syndrome, should be considered. We present an algorithm for the evaluation of positional renal pain and demonstrate the effectiveness of its treatment by laparoscopic surgery. Methods. Laparoscopic technique was used to resect the offending ovarian vein in a case of ovarian vein syndrome and to fix the kidney in position for a case of symptomatic nephroptosis. A review of the evaluation and management of these entities is presented. Results. The patient with nephroptosis and the patient with ovarian vein syndrome were both discharged on postoperative day 2, had complete relief of pain, and suffered no long-term complications. Conclusions. Nephroptosis and ovarian vein syndrome should be considered in the differential diagnosis of renal pain altered by change in position. Laparoscopy is an excellent approach for repair of these conditions because it is safe, effective, and causes minimal morbidity.
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