Transrenal Antegrade Ureteral Occlusion: Clinical Assessment of Indications, Technique and Outcomes

Asvadi, Nazanin H.; Arellano, Ronald S.

doi:10.1016/j.juro.2015.02.2964

“…A surgical approach is usually avoided due to postoperative complications and stickiness. In recent years, several approaches including a retrograde ureteral 6 approach and percutaneous nephrostomy have been developed in the field of endourology to address this complicated consequence, but neither of these two options is easy to accomplish [18][19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

“…Compared to endourology approaches and transperitoneal surgery, the intra-conduit NPS is a more mini-invasive and convenient approach [9,18] . It is a bedside procedure, but we cannot see the details of the conduit during this process, and the placement of the silicon tube might not be deep enough for certain reasons.…”

Section: Discussionmentioning

confidence: 99%

Conservative treatment for urinary fistula following ileal conduit urinary diversion : a simple method

Ye

¹

,

Liang²,

Tan³

et al. 2019

Preprint

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Background The presence of urinary fistula after ileal conduit urinary diversion is a challenging complication , and this study investigated the role of the intra-conduit negative pressure system (NPS) in the presence of urinary fistula following ileal conduit (IC) urinary diversion as a conservative treatment. Methods Using the intra-conduit NPS, a minor drainage tube was placed within a silicon tube to suck urine from the conduit with consistent negative pressure. Patients with urinary fistula following IC from August 2012 to July 2017 were recorded, and the clinical characteristics and outcome were retrospectively analyzed. Results The intra-conduit NPS was used as a primarily conservative treatment for 13 patients who suffered from urinary fistula and presented with a large amount of abdominal/pelvic drainage without other significant morbidities. The median age was 60 years old (42-74 years), and 7 patients were male. The median duration between the IC operation and the presence of urinary fistula was 15 days (2-28 days), and elevated creatinine levels were detected in the abdominal/pelvic drainage with a median level of 2114 µmol/L (636-388 µmol/L). A significant decrease in abdominal/pelvic drainage was identified in 12 patients. The median time that the NPS was used was 9 days (7-11 days). The other patient did not show any improvements after 2 days of observation and then underwent open surgery. With ureteral stenting, 2 abdominal drainage tubes and the intra-conduit NPS were placed during operation, no urine leakage was observed in the abdominal/pelvic field, and the patient was cured in 9 days. With a median follow-up of 22 months, no fistula recurrence or hydronephrosis was detected. Conclusion The intra-conduit negative pressure system is a feasible and promising way to cure urinary fistula following ileal conduit urinary diversion. Because this procedure is a mini-invasive and simple approach, it might represent an alternative in selected patients.

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“…Surgical approach is usually avoided for postoperative changes and complicated sticky. In recent years, endourology develops several approaches to deal with this complicated consequence: retrograde ureteral approach and percutaneous nephrostomy, but either of these two options is not easy to accomplish [18][19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

“…Compared to endourology approaches and transperitoneal surgery, intra-conduit NPS is more miniinvasive and convenient [9,18] . However, we can't see the details in the conduit during this bedside process, and the place of silicon tube might not be deep enough for some reasons.…”

Section: Discussionmentioning

confidence: 99%

A simple method for conservative treatment of urinary fistula following ileal conduit

Ye

¹

,

Heng²,

Tan³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

show abstract

“…A surgical approach is usually avoided due to postoperative complications and stickiness. In recent years, several approaches including a retrograde ureteral approach and percutaneous nephrostomy have been developed in the field of endourology to address this complicated consequence, but neither of these two options is easy to accomplish [18][19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

Conservative treatment for urinary fistula following ileal conduit urinary diversion : a simple method

Ye

¹

,

Liang²,

Tan³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background The presence of urinary fistula after ileal conduit urinary diversion is a challenging complication , and this study investigated the role of the intra-conduit negative pressure system (NPS) in the presence of urinary fistula following ileal conduit (IC) urinary diversion as a conservative treatment. Methods Using the intra-conduit NPS, a minor drainage tube was placed within a silicon tube to suck urine from the conduit with consistent negative pressure. Patients with urinary fistula following IC from August 2012 to July 2017 were recorded, and the clinical characteristics and outcome were retrospectively analyzed. Results The intra-conduit NPS was used as a primarily conservative treatment for 13 patients who suffered from urinary fistula and presented with a large amount of abdominal/pelvic drainage without other significant morbidities. The median age was 60 years old (42-74 years), and 7 patients were male. The median duration between the IC operation and the presence of urinary fistula was 15 days (2-28 days), and elevated creatinine levels were detected in the abdominal/pelvic drainage with a median level of 2114 µmol/L (636-388 µmol/L). A significant decrease in abdominal/pelvic drainage was identified in 12 patients. The median time that the NPS was used was 9 days (7-11 days). The other patient did not show any improvements after 2 days of observation and then underwent open surgery. With ureteral stenting, 2 abdominal drainage tubes and the intra-conduit NPS were placed during operation, no urine leakage was observed in the abdominal/pelvic field, and the patient was cured in 9 days. With a median follow-up of 22 months, no fistula recurrence or hydronephrosis was detected. Conclusion The intra-conduit negative pressure system is a feasible and promising way to cure urinary fistula following ileal conduit urinary diversion. Because this procedure is a mini-invasive and simple approach, it might represent an alternative in selected patients.

show abstract

Transrenal Antegrade Ureteral Occlusion: Clinical Assessment of Indications, Technique and Outcomes

Abstract: Percutaneous ureteral occlusion with platinum coils and Gelfoam offers a treatment option for patients with refractory urinary fistula and intractable hematuria in whom standard methods of urinary diversion fail.

Cited by 12 publications

References 22 publications

Conservative treatment for urinary fistula following ileal conduit urinary diversion : a simple method

Conservative treatment for urinary fistula following ileal conduit urinary diversion : a simple method

A simple method for conservative treatment of urinary fistula following ileal conduit

Conservative treatment for urinary fistula following ileal conduit urinary diversion : a simple method

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