Subcutaneous Nephrovesical and Nephrocutaneous Bypass

Abstract

Objective: We evaluated the effectiveness of the subcutaneous bypass for ureteral obstruction in patients with advanced malignancies. Two versions of the minimally invasive technique were performed: nephrovesical and nephrocutaneous bypass. Methods: A specially designed composite implant consisting of an inner smooth silicone-covered tube covered by a coiled e-PTFE-tube was used in 14 patients. Results: 10 subcutaneous nephrovesical bypasses were inserted in 10 patients, 8 nephrocutaneous bypasses in 4 patients. During the mean follow-up period of 13.1 months complications were observed in 2 patients with nephrocutaneous bypass, one encrustation and one infection of the bypass system. Conclusions: The subcutaneous nephrovesical and nephrocutaneous bypass is a safe alternative for palliative treatment of ureteral obstruction caused by pelvic malignancy.

Subcutaneous nephrovesical bypass: Treatment for ureteral obstruction in advanced metastatic disease

“…SNVB is not affected by the ipsilateral ureter and it offers minimal invasion, low risk and easy manipulation ( 13 ). Research shows that no severe complications occur during this operation, except for the occasional urinary extravasation and local infection ( 14 ).…”

Ureteral obstructions in dogs and cats: a review of traditional and new interventional diagnostic and therapeutic options

“…The development of an indwelling ureteral bypass device using a combination of locking‐loop nephrostomy and locking‐loop cystostomy catheters allows a nephrostomy tube to remain indwelling. In people, a different type of ureteral bypass has been demonstrated to improve the quality of life and reduce the complication rates when compared with externalized nephrostomy tubes, and have remained in situ long term when compared with the chronic encrustations seen with indwelling ureteral stents 47,48 …”

Subcutaneous pyelovesical bypass – Detour bypass – as a solution for ureteric obstruction

“…The least invasive treatment of ureteral obstruction is implantation of a ureteral Double J catheter. However, urinary drainage through the Double J catheter may by insufficient in some patients due to an external obstruction of the ureter or blockage of the stent lumen by mucus or necrotic material [ 3 , 4 ].…”

“…Percutaneous nephrostomy reduces quality of life as many patients withdraw themselves from social activities. There is a high rate of tube dislodgement, encrustation, infection and occlusion; therefore, the timespan between exchanges may be very short [ 2 , 3 ].…”