BACKGROUND: To evaluate the feasibility and efficacy of transrenal ureteral occlusion with microcoils in patients with ureterovaginal fistulas METHODS: Five women (median age 44 years, range 26-51 years) with ureterovaginal fistulas were treated by transrenal ureteral occlusion with microcoils. The underlying diseases were uterine fibroids (n = 3), a primitive neuroectodermal tumor of the uterine cervix (n = 1), and an ovarian cancer (n = 1). Microcoils with or without gelatin sponges, were placed antegradely through a percutaneous nephrostomy (PCN). A PCN tube was then placed to provide an external diversion RESULTS: The transrenal ureteral occlusion was technically successfully in all patients. Complete or near complete (<1 pad/day) dryness was obtained in all patients within 3 days. No complications other than a slight proximal migration of the microcoils in two patients occurred. The PCN tubes were removed in four of the five patients during the follow-up period with the subsequent procedures: antegrade ureteral stent placement, patent normal ureter, an ureteroneocystostomy and a laparoscopic end-to-end anastomosis of the ureter CONCLUSIONS: Transrenal ureteral occlusion with microcoils with or without gelatin sponges is a safe and reliable method for the management of patients with ureterovaginal fistulas.
BACKGROUND: To evaluate the feasibility and efficacy of transrenal ureteral occlusion with microcoils in patients with ureterovaginal fistulas METHODS: Five women (median age 44 years, range 26-51 years) with ureterovaginal fistulas were treated by transrenal ureteral occlusion with microcoils. The underlying diseases were uterine fibroids (n = 3), a primitive neuroectodermal tumor of the uterine cervix (n = 1), and an ovarian cancer (n = 1). Microcoils with or without gelatin sponges, were placed antegradely through a percutaneous nephrostomy (PCN). A PCN tube was then placed to provide an external diversion RESULTS: The transrenal ureteral occlusion was technically successfully in all patients. Complete or near complete (<1 pad/day) dryness was obtained in all patients within 3 days. No complications other than a slight proximal migration of the microcoils in two patients occurred. The PCN tubes were removed in four of the five patients during the follow-up period with the subsequent procedures: antegrade ureteral stent placement, patent normal ureter, an ureteroneocystostomy and a laparoscopic end-to-end anastomosis of the ureter CONCLUSIONS:Transrenal ureteral occlusion with microcoils with or without gelatin sponges is a safe and reliable method for the management of patients with ureterovaginal fistulas.
Authors: Rosario F Grasso; Roberto Luigi Cazzato; Giacomo Luppi; Simona Mercurio; Francesco Giurazza; Riccardo Del Vescovo; Eliodoro Faiella; Bruno Beomonte Zobel Journal: Indian J Radiol Imaging Date: 2014-04