Ureteric embolization: an alternative treatment strategy for urinary fistulae complicating advanced pelvic malignancy

Authors


Vaithianathan Natarajan, Urology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK. e-mail: V.Natarajan@sth.nhs.uk

Abstract

Palliative procedures have been developed for use as an alternative to major surgery in patients with a short life-expectancy due to advanced malignancy or other conditions. Authors from the UK describe a technique for ureteric embolization in such patients who have urinary fistulae, finding it to be safe and effective.

OBJECTIVE

To report experience with a minimally invasive technique for palliation of urinary fistula/incontinence complicating advanced pelvic malignancy or its treatment.

PATIENTS AND METHODS

We used ureteric embolization with permanent nephrostomy drainage in eight renal units in five patients for palliation of symptoms. All procedures were done under local anaesthesia as day-case procedures. Nephrostomy tubes were changed at regular intervals on an outpatient basis. Embolization was repeated when required.

RESULTS

The follow-up was 2–84 months; four patients died from the underlying malignancy during the follow-up. All patients were continent and had effective palliation of their symptoms. Two patients required repeat embolization. There were no embolization-related complications.

CONCLUSIONS

Ureteric embolization is a safe and effective minimally invasive palliative treatment option in urinary fistulae or incontinence complicating advanced pelvic malignancy.

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