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Objectives: Ureteral stents and ureteral catheters externalized through the urethra are not ideal solutions to manage complicated upper urinary tract fistulae. We sought an effective method of drainage, minimally invasive, reproducible allowing a rapid patient's discharge., Patients and Methods: Between November 2013 and February 2015, an ureteral stent was exteriorized in trans-vesico-parietal by an endoscopic and percutaneous access in patients with complicated upper urinary tract fistulae. Monitoring of tolerance, complications and urinary fistula healing was performed., Results: Nine consecutive patients had an ureteral stent exteriorized in trans-vesico-parietal to manage complicated upper urinary tract fistulae. There was no failure in introducing the catheter, or postoperative complication. Catheters were left in place on average 36.1days (24-55). The patients were able to return home with the catheter in place in 77.8% of cases. The tolerance of the catheter was good. All fistulae were able to be treated conservatively at the end of the drainage period., Conclusion: Trans-vesico-parietal ureteral catheters enable efficient and reproducible conservative treatment of upper tract urinary fistulae regardless of their cause., Level of Evidence: 5., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Introduction: Urinary fistula and ureteral stenosis occur respectively in 2-5% and 2-7.5% after kidney transplantation. The aim of the study was to do an overview about the complex management of these complications., Material and Methods: A bibliographical research in French and English language was carried out. Debates on the topic held within a meeting organized by the transplantation Committee of the French association of urology (CTAFU) have incremented the work., Results: Within the different causes of stenosis and fistula after kidney transplantation, ischemic diseases of the complex blood supply of the ureter are usually involved. The diagnosis is not always easy to establish. It is based on clinical assessment, blood and urinary biochemical exams, ultrasonography and CT-scan. Pyelography or retrograde ureteropyelography are essential in the management. Definitive treatment is surgical: uretero-vesical reimplatation, uretero-uretral anastomosis, pyelo-ureteral anastomosis., Conclusion: Urologic complications of the kidney transplantation usually do not affect the transplant survival if treated accurately and on time. The surgical management remains complex., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Chyluria is rare. The parasite that causes filariasis is the most common cause while the non-parasitic causes is anecdotal. Medical treatment is often insufficient to treat cases of chronic chyluria for which the standard treatment is surgical lymphatic disconnection renovascular. However, sclerotherapy by instillation of a sclerosing agent kidney may represent an alternative to surgery. This technique has the advantage of being less invasive than surgery and has a proven efficacy in the literature., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Chyluria is the passage of chyle into the urine giving it a typical milky appearance, it's due to a communication between lymphatic and urinary system. Filariasis is the most frequent cause of chyluria. Considering the infrequency of chyluria in our environment, a literature review is made, explaining the most frequent etiological data, as well as clinical signs, diagnostic means, conservative and surgical procedures in the treatment of this process.

Uretero-arterial fistulas are exceptional complications: only about forty cases have been reported in the literature. The authors report new two cases of fistula between the common iliac artery and the ureter. One fistula occurred in a context of prolonged ureteric stenting after radiotherapy and pelvic surgery for cancer of the uterus, and the other occurred after an aorto-bifemoral allograft. These fistulas generally occur in a particular clinical context, associating several aetiological factors. The clinical presentation is dominated by often massive and intermittent haematuria. The most useful diagnostic examinations are retrograde ureteropyelography and arteriography. The proposed treatment options (nephrectomy, vascular bypass graft and even embolization) depend on the urgency of the situation and involve both the blood vessel and the urinary tract. The prognosis depends on early diagnosis, but preventive measures can be envisaged to decrease the risk of appearance of these fistulas in high-risk patients.

Objective: Our purpose was to study aetiopathogenic, diagnostic and therapeutic aspects of ureterovaginal fistulas., Study Design: A retrospective study concerned 10 ureterovaginal fistulas. The main causes were gyneacoligical and obstetrical procedures. The diagnosis was based on clinical considerations and intravenous pyelography in all cases. Various therapeutic methods were used: Fistulas has managed in three cases by ureteroneocystostomy. Five cases were managed with ipsilateral ureteroureterostomy, the segment of ureter below the fistula was identified using ureteroscopic perforation of this segment in three cases. In one case the fistula was successfully managed by ureteroscopic placement of ureteral stent. In case whose fistula was developed after cancer pelvic we choice abstention., Results: Late radiology showed success of the procedure in 7 patients and persistance of hypotony in 2 cases treated by u reteroneocystostomy., Conclusion: Ureterofistula is rare, but a relative frequent complication of pelvic surgery whose prevention is the most efficient treatment. Ureteroureterostomy is a good procedure when ureteroscopy is performed.

Rigid ureteroscopy has become a common tool for the diagnosis and management of several diseases of the upper urinary tract. Between April 1990 and April 1996, 92 ureteroscopy procedures were performed in 88 patients in the B Urology Department of Avicennes hospital for diagnostic or therapeutic purposes. The commonest therapeutic procedure was stone manipulation (72 cases). The overall success rate was 90.8% (Distal ureter: 89.6%, mid ureter: 80%, lumbar ureter: 100%) and the complication rate was 4%. Therapeutic ureteroscopy was also used to dry ureterovaginal fistula (4 cases) and ureteral fistula with retroperitoneal urinoma (2 cases), and to remove a double J stent which had migrated into the pelvic ureter (3 cases). Diagnostic ureteroscopy was performed for 7 ureteral strictures including 3 extrinsic compressions and 4 ureteral strictures all treated with dilatations after biopsy. One false passage was observed among diagnostic ureteroscopy procedures. Rigid ureteroscopy is a minimally invasive and reliable technique for the management of ureteric calculi and for the diagnosis and treatment of other ureteric lesions.

The pancreaticoduodenocystostomy has become the most acquired technique to perform a combined pancreas-kidney-transplantation. This operation shows some disadvantages. There sometimes are urological problems. In this article, we describe two patients, who showed urethral problems due to this operation. At the same time, we would like to describe the possible causes and the preferable treatment of this rare complication. We advise to start with a conservative treatment and, if problems persist, to consider an intestinal conversion.

A case of uretero-uterine fistula leads the authors to analyse the possible causes and review the diagnosis approach, which is above all clinical:incontinence of urine with persistence of normal micturition; leakage of urine via the cervix and cystoscopically normal bladder, most often following cesarean section. Treatment possibilities are considered, with uretero-vesical reimplantation having a place of choice.

The authors report 5 cases of ureteric fistula after radical pelvic cancer surgery. Three patients had a recurrent tumour and 3 had received radiotherapy. Endourological methods achieved 4 immediately satisfactory results, but only one complete long-term success. Isolated percutaneous drainage of the pyelocaliceal cavities effectively dried up the urine leak, but carried a high risk of secondary stenosis of the excretory tract in the absence of concomitant intubation of the fistula zone. However, endourological treatment, combined with urinary diversion and catheterisation of the pathological ureter, represented a reliable alternative to conventional surgery.

The authors report three cases of postoperative urinary fistulae repaired by means of fibrin glue. This new therapeutic approach avoids the need for a difficult reoperation.

14 ureteral stenoses and 5 fistulae following an uro-intestinal anastomosis (UIA) were managed by a transrenal percutaneous approach. The stenoses (12 uretero-ileal and 1 uretero-colic anastomoses) were dilated with an angioplasty balloon and stented for several weeks. After withdrawal of the stent, performed on 12 out of 14 patients, the dilatation was successful in 8/12 cases (66%), with a follow up of 3 to 36 months. All the fistulae were dried. In 2 cases, complete recovery was achieved after placement of a bilateral nephrostomy tube. In 2 other cases, the ureter was stented at the site of the fistula which dried without sequelae after withdrawal of the stent. In the last case (uretero-colic diversion) surgery was performed after the fistula dried for the cure of a complete stenosis associated with the fistulae. The use of percutaneous nephrostomy is highly recommended for the management of post-operative stenoses and fistulae before considering surgical correction.

211 percutaneous nephrostomies (PCN) have been performed on 189 patients under combined fluoroscopic and reel time ultra-sound guidance. 4 major complications occurred with consisted in one hemorrhage and 3 septicemias. Indication of the PCN was diagnostic in 35 cases and therapeutic in 176 cases. Decompression of pyelo-caliceal system (89 cases) among with 72 in emergency, drying of an urinary fistula (8 cases), balloon dilatation of benign ureteral stenoses (18 cases) and treatment of 60 renal stones (3 dissolutions and 57 extractions). Results showed the drying of the fistula in all cases, the long term success of the balloon dilatation in 50% cases and 80% success rate of stone extraction.