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

Thierry de Baere, Alain Roche, Christine Lagrange, Alban Denys, Bernard Court, Joël Isapoff, Paris Pappas

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    Abstract

    Purpose To determine the efficacy of a cystoscopic approach, as definitive treatment of ureteral fistulae, after failure of antegrade ureteral stent insertion. Methods 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. Results 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. Conclusion 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.

    Original languageEnglish
    Pages (from-to)349-352
    Number of pages4
    JournalCardioVascular and Interventional Radiology
    Volume18
    Issue number6
    DOIs
    Publication statusPublished - 1 Jan 1995

    Keywords

    • Cystoscopy
    • Nephrostomy
    • Ureter interventional procedure
    • Ureteral disease
    • Ureteralstents

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