Percutaneous Cryoablation for Successful Treatment of a Persistent Urine Leak after Robotic-Assisted Partial Nephrectomy

Ward, Thomas J.; Ahmed, O.; Chung, Benjamin I.; Sze, Daniel Y.; Hwang, Gloria L.

doi:10.1016/j.jvir.2015.08.029

Cited by 11 publications

(6 citation statements)

References 15 publications

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“…In cases of persistent urinary fistula, various approaches have been reported, including double stenting, primary closure of the fistula (fibrin adhesive, N-butylcyanoacrylate and fulguration), reconstructive surgery including calyceal infundibular dilation, cryoablation, transarterial embolization (TAE), and nephrectomy [1][2][3][7][8][9][10][11]. Meeks et al reported that 5 of 21 cases of urinary fistula after partial nephrectomy presented anatomical causes, including two cases of infundibular stenosis of calix with a duration of the fistula of more than five months [2].…”

Section: Discussionmentioning

confidence: 99%

A case of refractory urinary fistula after partial nephrectomy treated with additional partial nephrectomy for suspected isolated calix

Katagiri

2023

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Introduction: Urinary fistula is the major complication after partial nephrectomy and is occasionally refractory to conservative treatments. Case Report: A 66-year-old man with renal cell carcinoma was treated with partial nephrectomy. Diagnosis of urinary fistula was triggered by drainage of perirenal abscess after surgery. Being refractory to ureteral stenting, a dilated ventral upper calix was detected in the subsequent fistulography, whereas the calix or its connection with the renal pelvis was not demonstrated in excretion phase of enhanced computed tomography. Considering the possibility of isolated calix due to infundibular injury besides the fistula communicating with the renal pelvis, we performed additional partial nephrectomy for the upper pole kidney and immediately closed the collecting system. The drain could be removed thereafter. Conclusion: We report the first case of refractory urinary fistula after partial nephrectomy treated with additional partial nephrectomy.

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Section: Discussionmentioning

confidence: 99%

A case of refractory urinary fistula after partial nephrectomy treated with additional partial nephrectomy for suspected isolated calix

Katagiri

2023

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“…При этом время дренирования ВМП может быть достаточно длительным для полного закрытия мочевой фистулы. J.J. Meek et al [11] [11,69,70], ретроградное или чрескожное использование фибринового или тканевого (N-бутил-2цианоакрилат) клеев [71,72,73,74,75], перкутанная криоабляция свищевого хода [76]. N.F.…”

Section: лечение мочевых фистул при пнunclassified

Urinary fistulas after partial nephrectomy in renal cell carcinoma

Гулиев¹

2021

Vestn. urol.

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Urinary fistulas after partial nephrectomy are rare complications of this operation. There are various reasons for their development, prevention and treatment. This review analyzes the results of the cases' prevalence of urine leakage after partial nephrectomy with various approaches, occurrence's predictors of urinary fistulas, possible ways of their intraoperative prevention and treatment methods. The obtained data show that the size of tumors, their endophytic nature and proximity to the kidney pelvicalyceal system, as well as suturing of its defect, can be predictors of the development of urinary fistulas (UFs). Some authors point to the influence of long ischemia time and high blood loss on the occurrence of UFs. The main method of treating UFs is ureteral stenting or percutaneous drainage of the kidney pelvicalyceal system. For long-term persistent UFs, the method of choice can be simultaneous introduction of 2 stents, retrograde or percutaneous injection of fibrin glue, percutaneous cryoablation of the UFs.

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“…If treatment of UF with ureteral stenting is not effective, studies suggest single clinical observations of simultaneous use of 2 stents, [6] retrograde or percutaneous injection of fibrin glue into the PCS, [7] antegrade use of N -butyl-2-cyanoacrilate, [8] and percutaneous cryoablation of the fistulous tract. [9] There is no unified treatment or clear algorithm for the rapid elimination of urinary leak after PN.…”

Section: Introductionmentioning

confidence: 99%

Management of persistent urine leak after partial nephrectomy: A case series

Гулиев¹,

Komyakov²,

Shevnin³

et al. 2022

Curr Urol

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Urinary leak is one of the most significant complications after partial nephrectomy. In case of persistent urine leaks, placement of a ureteral stent is effective but not always sufficient. This study included 5 patients with persistent urinary leak after partial nephrectomy. The patients underwent flexible ureteroscopy wherein we identified the damaged calyx. Subsequently, we performed percutaneous puncture targeting the distal end of the endoscope at this calyx and installed a nephrostomy tube. Then, the endoscope was removed, and the ureter was drained with a stent. Ureteral stenting ensures elimination of urinary leak in most patients after partial nephrectomy. In patients with persistent urinary leak, retrograde endoscopic percutaneous drainage of the pelvicalyceal system is the method of choice because it allows for rapid and effective treatment of urinary fistulas.

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Percutaneous Cryoablation for Successful Treatment of a Persistent Urine Leak after Robotic-Assisted Partial Nephrectomy

Cited by 11 publications

References 15 publications

A case of refractory urinary fistula after partial nephrectomy treated with additional partial nephrectomy for suspected isolated calix

A case of refractory urinary fistula after partial nephrectomy treated with additional partial nephrectomy for suspected isolated calix

Urinary fistulas after partial nephrectomy in renal cell carcinoma

Management of persistent urine leak after partial nephrectomy: A case series

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