Combined percutaneous antegrade and cystoscopic retrograde approach in the treatment of distal ureteric fistulae

Cardiovascular and Interventional Radiology
T de BaereP Pappas

Abstract

To determine the efficacy of a cystoscopic approach, as definitive treatment of ureteral fistulae, after failure of antegrade ureteral stent insertion. Of 43 ureter fistulae encountered over 4 years, 10 postoperative and/or postradiotherapy fistulae could not be stented via an antegrade approach alone. A cystoscopic approach was used, with the antegrade approach available as back-up, if necessary. In two patients the ureteral orifice could not be visualized cystoscopically, thus precluding the retrograde approach. In the eight remaining patients, the retrograde approach alone never allowed successful stenting. In six patients, combined antegrade and retrograde approaches permitted stent insertions. In three of those six patients, a complex catheterization procedure was necessary. In two patients the combined approach failed altogether. Therefore, 6 of 10 patients underwent a successful stenting procedure with the combined approach; all ultimately closed the fistula. Antegrade stent insertion remains the treatment of choice for ureteral leaks. If the antegrade approach fails, the retrograde approach alone is not likely to be successful. Instead, a combination of both approaches often does succeed.

References

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Citations

Sep 24, 2008·Cardiovascular and Interventional Radiology·K BoulougouriV Georgountzos
Jan 25, 2005·Clinical Radiology·A MacrìC Famulari
May 17, 2017·La Radiologia medica·Claudia TrombatoreVincenzo Magnano San Lio
Aug 7, 2008·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Bahri UstunsozAyfer Ustunsoz
Dec 17, 2004·Cardiovascular and Interventional Radiology·Hugh AndersonPatrick Joseph Edwin
Jun 14, 2020·Cardiovascular and Interventional Radiology·Hiroshi KawadaYasuaki Arai

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