Percutaneous Treatment Options of Lower Urinary Tract Fistulas and Leakages

Kuetting, Daniel; Pieper, Claus Christian

doi:10.1055/a-0581-5533

Cited by 3 publications

(4 citation statements)

References 44 publications

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“…Urinary fistula following ileal conduit is rather rare, but it is associated with severe comorbidities such as abdominal infection, ileus, and metabolism. Treatment is challenging especially when it comes following complicated pelvic organ resection and urinary diversion [6,[8][9] . For these fragile patients, management of urinary fistula preferred to be as minimally invasive as possible.…”

Section: Discussionmentioning

confidence: 99%

“…Urinary fistula after ileal conduit is rare, but the management of this complication is challenging [1][2][3][4] . Though ureteroenteric anastomosis and closure of conduit are both in risk of urine leakage, the management was almost similar as below: evaluate to ensure the urinary fistula, drainage the urine out, and then repair the fistula actively or conservatively [4][5][6][7][8] . Compared to surgical approaches, retrograde placement of stent and nephrostomy were the most common mini-invasive approaches to deal with urinary fistula following ileal conduit [8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Heng²,

Tan³

et al. 2019

Preprint

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Heng²,

Tan³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Urinary fistula following ileal conduit urinary diversion is rather rare, but it is associated with severe comorbidities such as abdominal infection, ileus, and metabolism impairment. Treatment is challenging, especially when it is administered following complicated pelvic organ resection and urinary diversion [6, 8, 9]. For these fragile patients, the management of urinary fistula should be as minimally invasive as possible.…”

Section: Discussionmentioning

confidence: 99%

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

Heng

Tan

et al. 2019

BMC Urol

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BackgroundThe 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.MethodsUsing 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.ResultsThe 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 7patients 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.ConclusionThe 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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“…Although ureteroenteric anastomosis and conduit closure both carry the risk of urine leakage, management is simple as follows: evaluate and ensure urinary fistula, drain the urine, and then repair the fistula actively or conservatively [4][5][6][7][8] . Compared to surgical approaches, retrograde stent placement and nephrostomy are more common mini-invasive approaches than surgical approaches for addressing the presence of urinary fistula following ileal conduit urinary diversion [8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

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

Liang²,

Tan³

et al. 2019

Preprint

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.

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Percutaneous Treatment Options of Lower Urinary Tract Fistulas and Leakages

Abstract: · Kuetting D, Pieper CC . Percutaneous Treatment Options of Lower Urinary Tract Fistulas and Leakages. Fortschr Röntgenstr 2018; 190: 692 - 700.

Cited by 3 publications

References 44 publications

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

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

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

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