Successful management of urethro-ileal pouch fistula by cynoacrylate glue instillation

Jindal, Tarun; Sharma, Raj Kumar; Kamal, Mir Reza; Mandal, Soumendra Nath; Mukherjee, Subhabrata; Dilip, K.

doi:10.1016/j.jpurol.2011.06.007

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…65 Endoscopic intrafistular injection of fibrin glue has been attempted. 66 Once within the tract, fibrin activates thrombin to form a clot, which mechanically seals the fistula by promoting wound healing by hemostasis, angiogenesis, and fibroblast proliferation.…”

Section: Management Of Fistulaementioning

confidence: 99%

Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease

Tharian

George

Navaneethan

2016

Inflammatory Bowel Diseases

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The role of endoscopy in inflammatory bowel disease (IBD) has grown over the last decade in both diagnostic and therapeutic realms. It aids in the initial diagnosis of the disease and also in the assessment of the extent and severity of disease. IBD is associated with development of multiple complications such as strictures, fistulae, and colon cancers. Endoscopy plays a pivotal role in the diagnosis of colon cancer in patients with IBD through incorporation of chromoendoscopy for surveillance. In addition, endoscopic resection with surveillance is recommended in the management of polypoid dysplastic lesions without flat dysplasia. IBD-associated benign strictures with obstructive symptoms amenable to endoscopic intervention can be managed with endoscopic balloon dilation both in the colon and small intestine. In addition, endoscopy plays a major role in assessing the neoterminal ileum after surgery to risk-stratify patients after ileocolonic resection and assessment of a patient with ileoanal pouch anastomosis surgery and management of postsurgical complications. Our article summarizes the current evidence in the role of endoscopy in the diagnosis and management of complications of IBD.

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Section: Management Of Fistulaementioning

confidence: 99%

Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease

Tharian

George

Navaneethan

2016

Inflammatory Bowel Diseases

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“…In the early postoperative period therefore there is room for attempts at fistula closure using minimally invasive techniques, and cyanoacrylate sealants offer new possibilities in this field. Until now there are only 5 single case reports [ 8 - 12 ], which obviously had all a favorable outcome, besides the only sizable clinical series of 13 cases cumulated in 9 years, documenting a success rate of 84.6% with a median follow-up of 35 months [ 6 ]. There is also an interesting recent report of minimally invasive treatment of 10 patients presenting persistent or massive urine leaks at the vescicorethral anastomosis following radical prostatectomy using cystoscopically cyanoacrylate mixed with lipiodol to fill retrogradely the anastomotic gap, followed by apposition of fibrin glue in direct contact with urine [ 13 ].…”

Section: Case Presentationmentioning

confidence: 99%

Minimally invasive treatment of urinary fistulas using N-butyl-2-cyanoacrylate: a valid first line option

et al. 2013

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BackgroundA few single case reports and only one clinical series have been published so far about the use of N-butyl-2-cyanoacrylate in the treatment of urinary fistulas persisting after conventional urinary drainage.Case presentationWe treated five patients with a mean age of 59.2 years presenting iatrogenic urinary fistulas which persisted following conventional drainage manouvres. There were 3 calyceal fistulas following open, laparoscopic and robotic removal of renal lesions respectively, one pelvic fistula after orthotopic ileal neobladder and a bilateral dehiscence of uretero-sigmoidostomy. We used open-end catheters of different sizes adopting a retrograde endoscopic approach for cyanoacrylate injection in the renal calyces, while a descending percutaneous approach via the pelvic drain tract and bilateral nephrostomies respectively was used for the pelvic fistulas. Fluoroscopic control was always used during the occlusion procedures. The amount of adhesive injected ranged between 2 and 5 cc and in one case the procedure was repeated. With a median follow-up of 11 months we observed clinical and radiological resolution in 4 cases (80%), while a recurrent and infected calyceal fistula after laparoscopic thermal renal damage during tumor enucleoresection required nephrectomy. No significant complications were documented.ConclusionsIn an attempt to spare further challenging surgery in patients that had been already operated on recently, minimally invasive occlusion of persistent urinary fistulas with N-butyl-2-cyanoacrylate represents a valid first line treatment, justified in cases when the urinary output is not excessive and there is a favorable ratio between the length and diameter of the fistulous tract.

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Management and Outcomes of Ileal Pouch-Urethral Fistulas

Accioly

Maspero²,

Zhao³

et al. 2023

Urology

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Successful management of urethro-ileal pouch fistula by cynoacrylate glue instillation

Cited by 3 publications

References 4 publications

Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease

Endoscopy in the Diagnosis and Management of Complications of Inflammatory Bowel Disease

Minimally invasive treatment of urinary fistulas using N-butyl-2-cyanoacrylate: a valid first line option

Management and Outcomes of Ileal Pouch-Urethral Fistulas

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