340 results on '"Urinary Fistula therapy"'
Search Results
202. [Giant urinoma of the thigh].
- Author
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Wolf RF, Elzen AH, de Jong IJ, Homan van der Heide JN, Jager PL, and Boeve WJ
- Subjects
- Aged, Chronic Disease, Diagnosis, Differential, Humans, Male, Urinary Catheterization adverse effects, Urinary Fistula etiology, Urinary Fistula therapy, Neoplasms diagnosis, Thigh, Urinary Fistula diagnosis
- Abstract
A man aged 70 during a hospital stay over a period of a few weeks developed increasing pain and swelling of the left thigh. Despite extensive diagnostic imaging and surgical drainage, initially no diagnosis could be established. After more than 3 months the tumour proved to be caused by leakage of urine from the pelvis to the soft tissues of the leg. Unfamiliarity of the clinicians with such an extension of an urinoma contributed to the considerable diagnostic delay. Introduction of a bladder catheter stopped the flow of urine to the leg and reduced the leg circumference. more...
- Published
- 1998
203. [Two cases of delayed ureteral fistulas following rectal amputation].
- Author
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Inoue K, Nishimura K, Isogawa Y, and Ohmori K
- Subjects
- Anastomosis, Surgical, Humans, Male, Middle Aged, Rectal Neoplasms surgery, Stents, Ureter surgery, Ureteral Diseases therapy, Urinary Bladder surgery, Urinary Fistula therapy, Postoperative Complications, Rectum surgery, Ureteral Diseases etiology, Urinary Fistula etiology
- Abstract
We report two rare cases of delayed ureteral fistulas which occurred one month following rectal amputation. Case 1 was a 52-year-old male who underwent abdominal perineal resection of the rectum. One month after surgery, the patient had a paralytic ileus. Computed tomographic (CT) scan and drip infusion pyelography showed left ureteral fistula and a large pelvic urinoma. Because retrograde placement of a double-J stent was unsuccessful, antegrade placement of the double-J stent was performed. The fistula and urinoma healed soon after the placement of the double J stent. Case 2 was a 43-year-old male who underwent abdominal sacral resection of the rectum. One month after surgery, a large amount of urine began to drain from the perineal wound. CT scan and retrograde pyelography showed a right ureteral fistula and a large pelvic urinoma. There had been temporary improvement in the discharge without the treatment of the ureteral fistula, only for it to return more profusely. Because placement of a double-J stent was unsuccessful, right percutaneous nephrostomy was performed, after which, a right ureterocysto-neostomy (Boari flap method) was performed. We advocate the initial use of the double-J stent or percutaneous nephrostomy in ureteral fistula. This approach is simple and may cure the fistula. If unsuccessful, it will not hinder subsequent open surgery. more...
- Published
- 1998
204. Embolization of iatrogenic vascular injuries of renal transplants: immediate and follow-up results.
- Author
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Dorffner R, Thurnher S, Prokesch R, Bankier A, Turetschek K, Schmidt A, and Lammer J
- Subjects
- Adult, Aneurysm, False diagnostic imaging, Aneurysm, False etiology, Aneurysm, False therapy, Angiography, Digital Subtraction, Arteriovenous Fistula diagnostic imaging, Arteriovenous Fistula etiology, Arteriovenous Fistula therapy, Female, Fistula diagnostic imaging, Fistula etiology, Fistula therapy, Humans, Kidney pathology, Kidney Diseases diagnostic imaging, Kidney Diseases etiology, Kidney Diseases therapy, Male, Middle Aged, Radiography, Interventional, Renal Artery diagnostic imaging, Renal Veins diagnostic imaging, Urinary Fistula diagnostic imaging, Urinary Fistula etiology, Urinary Fistula therapy, Vascular Diseases diagnostic imaging, Vascular Diseases etiology, Vascular Diseases therapy, Biopsy, Needle adverse effects, Embolization, Therapeutic, Kidney Transplantation, Renal Artery injuries, Renal Veins injuries
- Abstract
Purpose: To evaluate the outcome in seven patients in whom iatrogenic vascular complications were treated with catheter embolization., Methods: Angiography showed an arteriovenous fistula in six of the seven patients, a pseudoaneurysm in three patients, and an arteriocaliceal fistula in three patients. Embolization was performed with GAW coils or microcoils in all cases. In three patients enbucrilate, polyvinyl alcohol, or absorbable gelatin powder was administered as an adjunct to the coils., Results: Angiographic success with total occlusion of the vascular injury was achieved in five of the seven patients and clinical success was achieved in four of seven cases. In two cases, nephrectomy after embolization was necessary because of renal artery occlusion or acute hemorrhage at the renal artery anastomosis, respectively. Infarction of 30%-50% of the renal parenchyma was seen in two cases., Conclusion: Angiographically successful embolization is not necessarily associated with clinical success. The complication rate is high. more...
- Published
- 1998
- Full Text
- View/download PDF
205. Ultrasound-guided percutaneous nephrostomy in non-dilated pelvicaliceal system.
- Author
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Gupta S, Gulati M, and Suri S
- Subjects
- Child, Constriction, Pathologic therapy, Dilatation, Diuretics administration & dosage, Diuretics therapeutic use, Furosemide administration & dosage, Furosemide therapeutic use, Humans, Injections, Intravenous, Nephrostomy, Percutaneous instrumentation, Pelvic Neoplasms complications, Postoperative Complications, Rhabdomyosarcoma, Embryonal complications, Ureter injuries, Ureteral Diseases therapy, Urinary Fistula therapy, Kidney Calices diagnostic imaging, Kidney Pelvis diagnostic imaging, Nephrostomy, Percutaneous methods, Ultrasonography, Interventional
- Abstract
Percutaneous placement of nephrostomy catheters in patients with non-dilated pelvicaliceal systems remains problematic. We successfully performed ultrasound-guided percutaneous nephrostomies in 5 such patients after intravenous administration of a diuretic agent. Diuresis resulted in transient dilatation of the calyces, facilitating the procedures, which were performed under real-time sonographic guidance using the Seldinger technique. No complications were encountered. more...
- Published
- 1998
- Full Text
- View/download PDF
206. Percutaneous embolization of a posttraumatic nephrobiliary fistula.
- Author
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Ryu R, Novak Z, and Coldwell D
- Subjects
- Abdominal Injuries complications, Adolescent, Biliary Fistula etiology, Female, Humans, Kidney Diseases etiology, Liver Diseases etiology, Urinary Fistula etiology, Biliary Fistula therapy, Embolization, Therapeutic, Kidney Diseases therapy, Liver Diseases therapy, Urinary Fistula therapy, Wounds, Gunshot complications
- Published
- 1998
- Full Text
- View/download PDF
207. Successful closure of neovesicocutaneous fistula with fibrin glue.
- Author
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Morita T, Tachikawa N, and Tokue A
- Subjects
- Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Complications, Urinary Bladder Neoplasms surgery, Urinary Fistula diagnostic imaging, Urinary Fistula etiology, Urography, Fibrin Tissue Adhesive therapeutic use, Ileum, Tissue Adhesives therapeutic use, Urinary Fistula therapy, Urinary Reservoirs, Continent adverse effects
- Abstract
We report a case of neovesicocutaneous fistula following radical cystectomy with urinary diversion via an ileal neobladder. The fistula was closed with fibrin glue. The present case suggests that occlusion therapy with fibrin glue is useful as a treatment option to facilitate the closure of a fistulous tract in the case of prolonged urine leakage from the ileal neobladder. more...
- Published
- 1998
- Full Text
- View/download PDF
208. [Rigid ureteroscopy. Apropos of 88 cases].
- Author
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el Khader K, Koutani A, el Yazidi A, Ibn Attya A, Hachimi M, and Lakrissa A
- Subjects
- Adolescent, Adult, Constriction, Pathologic diagnosis, Constriction, Pathologic therapy, Dilatation, Female, Foreign-Body Migration therapy, Humans, Male, Middle Aged, Minimally Invasive Surgical Procedures, Reproducibility of Results, Retroperitoneal Space, Stents adverse effects, Treatment Outcome, Ureteral Calculi therapy, Ureteral Diseases diagnosis, Ureteral Diseases therapy, Ureteroscopes, Ureteroscopy adverse effects, Urinary Fistula therapy, Urine, Vaginal Fistula therapy, Ureteroscopy methods
- Abstract
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. more...
- Published
- 1998
209. Percutaneous nephrostomy: a non-operative management of urinomas: 2 case reports.
- Author
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Tanveer-ul-Haq, Rizvi IH, Khan ZA, and Khan AA
- Subjects
- Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Nephrostomy, Percutaneous methods, Peritoneal Diseases diagnostic imaging, Radiography, Retroperitoneal Space, Ureteral Diseases diagnostic imaging, Urinary Fistula diagnostic imaging, Nephrostomy, Percutaneous instrumentation, Peritoneal Diseases therapy, Stents, Ureteral Diseases therapy, Urinary Fistula therapy
- Published
- 1998
210. Hypogastric arterial-ureteral fistula.
- Author
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Sexton WJ, Routh WD, McCullough DL, and Bare RL
- Subjects
- Arteries, Female, Hodgkin Disease complications, Humans, Middle Aged, Radiography, Ureteral Diseases diagnostic imaging, Ureteral Diseases therapy, Urinary Fistula diagnostic imaging, Urinary Fistula therapy, Vascular Fistula diagnostic imaging, Vascular Fistula therapy
- Published
- 1998
- Full Text
- View/download PDF
211. [The double-J ureteral catheter. Clinical indications].
- Author
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Vallejo Herrador J, Burgos Revilla FJ, Maganto Pavón E, Téllez Martínez-Fornés M, Sánchez de la Muela Naverac P, and Martín-Laborda Bergasa F
- Subjects
- Humans, Kidney Transplantation adverse effects, Ureteral Calculi complications, Ureteral Calculi therapy, Ureteral Obstruction surgery, Catheters, Indwelling, Ureteral Diseases therapy, Ureteral Obstruction therapy, Urinary Catheterization instrumentation, Urinary Fistula therapy
- Abstract
Objective: To analyze the clinical indications of double-J ureteral catheters., Methods: The most relevant studies published in the literature since the self-retained indwelling catheter was first described in 1967 are reviewed., Results: The experience and results reported in the most relevant studies are presented., Conclusions: The double J ureteral catheter is essential in urological practice. Although its clinical indications are well-established, its use depends on the urologist's experience in most of the cases. more...
- Published
- 1997
212. [Etiology and treatment of secondary lesions of the urethra: unusual complication of a combined kidney-pancreas transplantation].
- Author
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St Bataille, Kimpe B, and Baert L
- Subjects
- Adult, Diabetic Nephropathies surgery, Duodenum surgery, Humans, Male, Middle Aged, Urethral Diseases surgery, Urethral Diseases therapy, Urethral Stricture surgery, Urethral Stricture therapy, Urinary Bladder surgery, Urinary Fistula surgery, Urinary Fistula therapy, Kidney Transplantation adverse effects, Pancreas Transplantation adverse effects, Urethral Diseases etiology, Urethral Stricture etiology, Urinary Fistula etiology
- Abstract
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. more...
- Published
- 1997
213. [Treatment of recto-urethral fistulas in Crohn's disease].
- Author
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Aiello C, Santoro GA, Cerbone V, de Werra C, Gentile M, and Bucci L
- Subjects
- Adult, Anti-Infective Agents therapeutic use, Crohn Disease surgery, Follow-Up Studies, Humans, Immunosuppressive Agents therapeutic use, Male, Metronidazole administration & dosage, Metronidazole therapeutic use, Rectal Fistula etiology, Rectal Fistula surgery, Time Factors, Urethral Diseases etiology, Urethral Diseases surgery, Urinary Fistula etiology, Urinary Fistula surgery, Crohn Disease complications, Rectal Fistula therapy, Urethral Diseases therapy, Urinary Fistula therapy
- Abstract
We report the thirteenth case of a rectourethral fistula in Crohn's disease. The patient, a 37 year-old-white male, had a 20 year history of intestinal Crohn's disease and had undergone numerous bowel resections. His symptoms were fecaluria, urorrhea and passing of urine from an orifice just outside the base of the scrotum. He had urinary infection and severe ileocolitis. He underwent a diagnostic evaluation that revealed a fistula comprising the membranous urethra, the rectum, the perineum and the scrotum. We performed medical therapy with metronidazole (20 mg/kg/day/12 months). We present in this article a review of the literature on the management of rectourethral fistulas in Crohn's disease. Surgeons have successfully used several approaches in the repair of this disorder, but no single procedure had proved to be best or even universally applicable. We emphasize, as the literature suggests, that management must be individualized. Medical therapy with metronidazole has an important role in a patient with rectourethral fistula and concomitant proctitis, ileocolitis, urinary sepsis and multiple previous surgeries. more...
- Published
- 1997
214. Diagnosis and management of ureteroiliac artery fistula: value of provocative arteriography followed by common iliac artery embolization and extraanatomic arterial bypass grafting.
- Author
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Vandersteen DR, Saxon RR, Fuchs E, Keller FS, Taylor LM Jr, and Barry JM
- Subjects
- Adult, Aged, Algorithms, Combined Modality Therapy, Female, Femoral Artery transplantation, Humans, Middle Aged, Radiography, Arteriovenous Fistula diagnostic imaging, Arteriovenous Fistula therapy, Embolization, Therapeutic, Iliac Artery diagnostic imaging, Ureteral Diseases diagnostic imaging, Ureteral Diseases therapy, Urinary Fistula diagnostic imaging, Urinary Fistula therapy
- Abstract
Purpose: We describe an effective multidisciplinary approach to the diagnosis and management of ureteroarterial fistulas that reduces morbidity and mortality., Materials and Methods: Five ureteroarterial fistulas in 4 patients were studied with standard and provocative arteriography (arteriography combined with ureteral manipulation). After establishing the diagnosis, each lesion was treated with percutaneous embolic occlusion of the common iliac artery followed by extraanatomic arterial bypass grafting. All patients had chronic ureteral stenting, prior pelvic irradiation, prior pelvic surgery and intrapelvic malignancy, and all fistulas presented with urinary tract hemorrhage., Results: Standard arteriography was nondiagnostic but provocative arteriography demonstrated the fistula in each case. Successful embolization of the common iliac artery followed by extraanatomic arterial bypass grafting precluded the need for laparotomy and preserved ipsilateral renal function., Conclusions: Provocative arteriography followed by arteriographic common iliac artery embolization and extraanatomic bypass grafting was successful for the diagnosis and treatment of ureteroarterial fistulas. There was no mortality, limb loss or renal loss. more...
- Published
- 1997
215. Experimental evaluation of a new device for percutaneous transrenal ureteral occlusion.
- Author
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Marr B, Wright KC, Carrasco CH, and Brewer L
- Subjects
- Animals, Kidney pathology, Swine, Swine, Miniature, Urinary Fistula therapy, Stents, Ureter pathology
- Abstract
Purpose: To develop a device for percutaneous transrenal ureteral occlusion., Materials and Methods: The device was a double-body Gianturco-Rösch biliary stent constrained at the junction of the two stents to create an hourglass shape. One stent was coated with silicone. One device was percutaneously placed in each of nine pigs through a 9-F Teflon sheath. Urographic and hematologic follow-up was performed for up to 12 weeks., Results: Seven pigs showed immediate, complete ureteral occlusion, and two pigs exhibited persistent incomplete high-grade obstruction. All animals exhibited varying degrees of hydronephrosis and hydroureter. No device migration was noted. Minor complications were encountered during device placement in three pigs. Mucosal folds and villus-like projections that arose from the lamina propria protruded into the lumen of the ureter at the cranial end of the covered stent and around the wire of the caudal stent. Varying degrees of mural inflammation and edema were noted., Conclusion: Transrenal ureteral occlusion with the described device appears to be a viable method for treating urinary fistulas. more...
- Published
- 1997
- Full Text
- View/download PDF
216. Update on interventional uroradiology.
- Author
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Dyer RB, Assimos DG, and Regan JD
- Subjects
- Cystoscopy methods, Humans, Urography, Kidney Diseases therapy, Lithotripsy, Nephrostomy, Percutaneous, Radiography, Interventional, Ureteral Diseases therapy, Urinary Fistula therapy
- Abstract
From its humble beginnings as a method of expediently decompressing the obstructed kidney, the field of interventional uroradiology has evolved in the hands of urologists and interventional radiologists to a means of addressing myriad problems in the urinary tract and has changed the day-to-day practice of urology. The foundation of interventional uroradiology is the creation of an appropriate entry into the urinary system. After a review of this basic procedure, extensions of the technique and new applications of emerging technology are reviewed. more...
- Published
- 1997
- Full Text
- View/download PDF
217. Transcolonic placement of a percutaneous nephrostomy tube: recognition and treatment.
- Author
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Miller GL and Summa J
- Subjects
- Adult, Colonic Diseases diagnostic imaging, Colonic Diseases therapy, Female, Humans, Intestinal Fistula diagnostic imaging, Intestinal Fistula therapy, Kidney Diseases diagnostic imaging, Kidney Diseases therapy, Radiography, Urinary Fistula diagnostic imaging, Urinary Fistula therapy, Colonic Diseases etiology, Intestinal Fistula etiology, Kidney Diseases etiology, Nephrostomy, Percutaneous adverse effects, Urinary Fistula etiology
- Published
- 1997
- Full Text
- View/download PDF
218. Percutaneous nephrostomy with real-time sonographic guidance.
- Author
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Gupta S, Gulati M, Uday Shankar K, Rungta U, and Suri S
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Equipment Failure, Evaluation Studies as Topic, Female, Fluoroscopy, Humans, Infant, Male, Middle Aged, Nephrostomy, Percutaneous adverse effects, Nephrostomy, Percutaneous instrumentation, Radiography, Interventional, Retrospective Studies, Safety, Urinary Catheterization adverse effects, Urinary Catheterization instrumentation, Urinary Fistula therapy, Urologic Diseases therapy, Urologic Neoplasms therapy, Nephrostomy, Percutaneous methods, Ultrasonography, Interventional
- Abstract
Purpose: Percutaneous nephrostomy (PCN) is an effective method for achieving temporary drainage of the obstructed urinary system and is usually performed under fluoroscopic guidance alone or more commonly under combined sonographic and fluoroscopic guidance. We undertook a retrospective analysis of 273 PCNs performed solely under ultrasound (US) guidance with the aim of evaluating the technique and the safety and efficacy of the procedure., Material and Methods: A total of 273 PCN procedures in 267 patients were performed under real-time US guidance using the Seldinger technique. The indications for PCNs comprised benign (n = 215) and malignant (n = 46) urinary obstruction, and urinary fistulae (n = 6)., Results: PCN was successful in 269 of the 273 attempts (98.5%). Satisfactory catheter placement was achieved in 245 of the 269 procedures (91.1%) under US guidance. Fluoroscopic assistance for catheter repositioning was required in 24 PCNs owing to the unsatisfactory position of the catheter tip. Major complications occurred in 15 patients (5.6%). Catheter dislodgement and catheter blockage was seen in respectively 12.6% and 3.3% of procedures., Conclusion: In most patients, PCN can be performed safely using real-time sonographic guidance. more...
- Published
- 1997
- Full Text
- View/download PDF
219. Delayed presentation of post-traumatic internal pudendal arterial-urethral fistula, with successful embolization as therapy.
- Author
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Borgaonkar SS and Dux A
- Subjects
- Accidents, Traffic, Adolescent, Fractures, Bone, Humans, Male, Embolization, Therapeutic methods, Fistula therapy, Multiple Trauma, Peripheral Vascular Diseases therapy, Urethral Diseases therapy, Urinary Fistula therapy
- Published
- 1997
- Full Text
- View/download PDF
220. Endourologic diagnosis and treatment of ureterouterine fistula.
- Author
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Wang AC and Hung CF
- Subjects
- Adult, Female, Fistula diagnostic imaging, Humans, Tomography, X-Ray Computed, Ureteral Diseases diagnostic imaging, Urinary Fistula diagnostic imaging, Uterine Diseases diagnostic imaging, Fistula therapy, Ureteral Diseases therapy, Urinary Fistula therapy, Uterine Diseases therapy
- Abstract
A rare case of ureterouterine fistula following a dilatation and evacuation for elective abortion is presented. According to the literature, most cases are related to elective abortion. A 42-year-old woman, 1-0-5-1, presented with copious watery vaginal discharge from the cervical os. She had had an elective abortion followed by a laparotomy for a suspected uterine perforation with peritonitis 1 months prior to presentation. She underwent another laparotomy, which revealed only adhesion of the terminal ileum, appendix and adnexae based on the hysterogram, which suggested an enterouterine fistula. The right ureterouterine fistula was not diagnosed until an antegrade pyelogram was undertaken. She was subsequently treated with temporary percutaneous nephrostomy drainage followed by ureteroneocystostomy. It was concluded that the ureterouterine fistula was most likely caused by the lateral path of abortion instruments into the retroperitoneal space, with trauma to the right ureter. more...
- Published
- 1997
- Full Text
- View/download PDF
221. A one-stage dorsal free-graft urethroplasty for bulbar urethral strictures.
- Author
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Barbagli G, Selli C, di Cello V, and Mottola A
- Subjects
- Adult, Aged, Aged, 80 and over, Follow-Up Studies, Humans, Male, Middle Aged, Surgery, Plastic, Urinary Catheterization, Urinary Fistula etiology, Urinary Fistula therapy, Skin Transplantation methods, Urethral Stricture surgery
- Abstract
Objective: To report the use of one-stage dorsal free-graft urethroplasty to reduce the incidence of urethrocele., Patients and Methods: From 1990 to 1994, 20 men (age range 21-86 years) underwent a one-stage dorsal free-graft urethroplasty of bulbar urethral strictures (iatrogenic in 12, traumatic in three, inflammatory in three and unknown in two). All patients except one had been treated previously by optical urethrotomy from one to 14 times., Results: Temporary fistulae were detected on post-operative urethrography in three patients with particularly long grafts, but they all resolved spontaneously. Within a mean follow-up of 46 months, only one patient had a short recurrent stricture, which was treated successfully by optical urethrotomy. Two patients complained of post-voiding dribbling, but radiographic studies never showed graft weakening and the urinary flow rate was always > 14 mL/s., Conclusion: Free skin grafts can be applied successfully to the dorsal aspect and by doing so the complications of urethral reconstruction can be reduced. more...
- Published
- 1996
- Full Text
- View/download PDF
222. Ureteroarterial fistula: case report and review of the literature.
- Author
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Batter SJ, McGovern FJ, and Cambria RP
- Subjects
- Adult, Aged, Female, Humans, Aorta, Abdominal, Arteriovenous Fistula diagnosis, Arteriovenous Fistula etiology, Arteriovenous Fistula therapy, Femoral Artery, Iliac Artery, Ureteral Diseases diagnosis, Ureteral Diseases etiology, Ureteral Diseases therapy, Urinary Fistula diagnosis, Urinary Fistula etiology, Urinary Fistula therapy
- Abstract
Ureteroarterial fistulae are rare. We report 2 cases of this clinical problem. Ureteroarterial fistulae can occur in association with prolonged ureteral stenting, radiation therapy, vascular pathology, and prior pelvic or vascular surgery. Identification of a fistula is often difficult and requires the physician to be highly alert and vigilant. Diagnostic and therapeutic options for a ureteroarterial fistula are discussed. more...
- Published
- 1996
- Full Text
- View/download PDF
223. [Genitourinary fistulae at the National Institute of Perinatology].
- Author
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Villagrán-Cervantes R, Rodríguez-Colorado S, Delgado-Urdapilleta J, and Kunhardt-R J
- Subjects
- Female, Humans, Retrospective Studies, Urinary Fistula etiology, Urinary Fistula therapy, Vaginal Fistula etiology, Vaginal Fistula therapy
- Abstract
Evaluation of the characteristics of urogenital fistula with a retrospective study at the clinic of Urology Ginecologica in the Instituto Nacional de Perinatologia between March 1992 to June 1995, information of the location, etiopathogenesis of the disease, urinary tract infection and surgical treatment were obtained form de patients records in the clinic. The etiophatogenesis of the disease was surgical gynecological procedures in 51.1%, and obstetric cause 48.5%; the location were 14 (66.6%) vesicovaginal, 5 (23.5% 0 ureterovaginal and 2 (urethrovaginal). The abdominal approach were in 8 patients and vaginal route in 9, no surgical treatment were 2. Successfully repair fistula were in 80.9%. Urinary tract infections before treatment agreed on the obstetric etiology was 47.6%, and for surgical gynecological procedures 52.2%. There is an increase in the incident of obstetric vesicovaginal fistula, we believe it depends on the patients that we have in de Instituto Nacional de Perinatologia, most of them are obstetric patients. more...
- Published
- 1996
224. Occlusion therapy for an intractable transplant-ureteral fistula using fibrin glue.
- Author
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Tsurusaki T, Sakai H, Nishikido M, Matsuya F, Kanetake H, and Saito Y
- Subjects
- Adult, Humans, Male, Ureteral Diseases etiology, Urinary Fistula etiology, Fibrin Tissue Adhesive therapeutic use, Kidney Transplantation adverse effects, Tissue Adhesives therapeutic use, Ureteral Diseases therapy, Urinary Fistula therapy
- Published
- 1996
225. Nonsurgical management strategies for the functional complications of ileocolonic continent urinary reservoirs.
- Author
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Hartenbach EM, Saltzman AK, Carter JR, Fowler JM, Hunter DW, Carlson JW, Twiggs LB, and Carson LF
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Middle Aged, Radiography, Retrospective Studies, Treatment Outcome, Ureter diagnostic imaging, Ureteral Obstruction etiology, Ureteral Obstruction therapy, Urinary Calculi etiology, Urinary Calculi therapy, Urinary Catheterization, Urinary Fistula etiology, Urinary Fistula therapy, Proctocolectomy, Restorative adverse effects, Urinary Reservoirs, Continent adverse effects
- Abstract
Urinary diversion with creation of a continent ileocolonic reservoir was performed in 25 patients with gynecological malignancies at our institution between September 1989 and September 1994. A retrospective review was conducted and cases were analyzed for functional complications associated with reservoir formation. Functional reservoir complications were defined as (1) difficulty with catheterization, (2) reservoir fistulae, (3) reservoir stones, and (4) ureteral stenosis. Management strategies and outcomes for these complications were determined. All patients had received prior pelvic radiation therapy. There was no surgical mortality. Median follow-up was 21 months, and 16 patients (64%) are currently alive. Fourteen of the patients (56%) had one or more complications attributable to a functional aspect of the continent reservoir. Two patients had difficulty with catheterization (8%), two patients had reservoir leak (8%), and one patient had reservoir stones (4%). Nonsurgical management strategies were used in these cases including balloon dilation of the ileocecal valve, stomal dilation, ureteral stenting, percutaneous nephrostomy, and endoscopic lithotripsy. All cases of catheterization problems, reservoir fistulae, and reservoir stones were resolved with nonoperative techniques. Thirteen of 50 ureters (26%) had some degree of stenosis. Percutaneous balloon dilation was utilized in nine cases of ureteral stenosis. Relief of stenosis was complete in five, partial in two, and not achieved in two of the cases. No patients required a reoperation for a reservoir complication. In conclusion, continent ileocolonic urinary diversion can be performed in patients previously treated with radiotherapy; however, functional reservoir problems may occur. Interventional radiology strategies are useful in managing many of these problems and reexploration can be successfully avoided. more...
- Published
- 1995
- Full Text
- View/download PDF
226. Combined percutaneous antegrade and cystoscopic retrograde approach in the treatment of distal ureteric fistulae.
- Author
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de Baere T, Roche A, Lagrange C, Denys A, Court B, Isapoff J, and Pappas P
- Subjects
- Adult, Aged, Cystoscopy methods, Female, Humans, Male, Middle Aged, Nephrostomy, Percutaneous, Radiology, Interventional methods, Treatment Failure, Urinary Catheterization methods, Vaginal Fistula therapy, Stents, Ureteral Diseases therapy, Urinary Fistula therapy
- 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. more...
- Published
- 1995
- Full Text
- View/download PDF
227. [A case of a successfully conservatively treated ureterovaginal fistula of gynecological origin].
- Author
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Petrov P and Neĭkov K
- Subjects
- Combined Modality Therapy, Female, Humans, Middle Aged, Postoperative Complications etiology, Prostheses and Implants, Ureter, Ureteral Diseases etiology, Urinary Fistula etiology, Vaginal Fistula etiology, Hysterectomy adverse effects, Postoperative Complications therapy, Ureteral Diseases therapy, Urinary Fistula therapy, Vaginal Fistula therapy
- Published
- 1995
228. Urologic complications of renal transplantation.
- Author
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Van Cangh PJ, Wese FX, Opsomer R, Pirson Y, and Squifflet JP
- Subjects
- Erectile Dysfunction etiology, Female, Humans, Infertility etiology, Male, Neoplasms etiology, Ureteral Obstruction diagnosis, Ureteral Obstruction etiology, Ureteral Obstruction therapy, Urinary Calculi etiology, Urinary Diversion methods, Urinary Fistula diagnosis, Urinary Fistula etiology, Urinary Fistula therapy, Vesico-Ureteral Reflux etiology, Kidney Transplantation, Postoperative Complications etiology, Urologic Diseases etiology
- Published
- 1994
229. Endourologic management of complications in renal allografts.
- Author
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Pardalidis NP, Waltzer WC, Tellis VA, Jarrett TW, and Smith AD
- Subjects
- Humans, Kidney Calculi therapy, Transplantation, Homologous, Ureteral Obstruction therapy, Urinary Fistula therapy, Urologic Diseases diagnosis, Urologic Diseases etiology, Kidney Transplantation adverse effects, Urologic Diseases therapy
- Abstract
Because of the altered anatomy, the presence of immunosuppression, the possibility of graft rejection, and the serious implications of a problem involving a solitary kidney, the transplanted kidney presents unique challenges in the diagnosis and treatment of urologic complications. Historically, the mortality rate in these patients has been as high as 68%, and as many as 15% of the allografts have been lost. Today, endourologic procedures are used for prompt diagnosis, temporization, and even definitive management of many urologic complications, and many patients and allografts are being saved. The authors review present techniques and suggest others that may be available in the future. more...
- Published
- 1994
- Full Text
- View/download PDF
230. [Non-surgical treatment of urethral fistula: a suggested technic].
- Author
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Polito MJ, Antico E, Mantovani P, Candelari R, and Chierigo P
- Subjects
- Aged, Humans, Male, Radiography, Urethral Diseases diagnostic imaging, Urinary Fistula diagnostic imaging, Enbucrilate therapeutic use, Urethral Diseases therapy, Urinary Fistula therapy
- Abstract
The urethral fistulas need for recovery the traditional surgical approach. Recently are available for surgeons substances and devices particularly compatible with biological tissue and very safe. We have taken advantage of this good opportunity to treat an old and multiple fistula of the urethra in the perineum. We are completely satisfied of this, alternative method that lead the patient to recover, avoiding in the same time the risks of another surgical operation too, that is difficult and complicated. more...
- Published
- 1994
231. Endourological management of urological complications following renal transplantation.
- Author
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Streem SB
- Subjects
- Humans, Ureteral Obstruction etiology, Urinary Calculi etiology, Urinary Fistula etiology, Algorithms, Kidney Transplantation adverse effects, Ureteral Obstruction therapy, Urinary Calculi therapy, Urinary Fistula therapy
- Published
- 1994
232. Angiographic evaluation and therapy of ureteroarterial fistulas.
- Author
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Quillin SP, Darcy MD, and Picus D
- Subjects
- Adult, Aged, Causality, Embolization, Therapeutic, Female, Fistula epidemiology, Fistula therapy, Humans, Middle Aged, Radiography, Retrospective Studies, Ureteral Diseases epidemiology, Ureteral Diseases therapy, Urinary Fistula epidemiology, Urinary Fistula therapy, Fistula diagnostic imaging, Iliac Artery diagnostic imaging, Ureteral Diseases diagnostic imaging, Urinary Fistula diagnostic imaging
- Abstract
Objective: Fistulas between the iliac artery and the ureter are extremely uncommon, life-threatening conditions usually seen in patients who have had pelvic irradiation or have indwelling ureteral stents. We describe our experience in the angiographic evaluation and therapy of these fistulas., Materials and Methods: We retrospectively reviewed medical records for diagnoses of ureteroarterial fistulas. Patients' records were evaluated for potentially associated etiologic factors, clinical features and course, radiographic evaluation and findings, and therapy., Results: Our review showed that four patients treated at our institution (all since 1990) had ureteroarterial fistulas. All four patients had indwelling ureteral stents and had had irradiation for pelvic cancer. Three had spontaneous brisk hemorrhage in the urinary tract. The fourth had hemorrhage after balloon dilatation of a ureteral stricture. Initial diagnosis was based on findings on iliac arteriography in three patients and on findings on retrograde ureterography in one. Angiographic techniques required to visualize the fistulas included selective arterial catheterization, use of multiple projections, and provocative maneuvers. Treatment of the ureteroarterial fistulas involved surgery in one case, isolated embolotherapy in one case, and a combination of embolotherapy and surgery in two cases., Conclusion: Specific angiographic maneuvers are often required to identify ureteroarterial fistulas. Transcatheter embolotherapy (with or without surgical bypass) is an effective form of treatment for this rare abnormality. more...
- Published
- 1994
- Full Text
- View/download PDF
233. Transrenal ureteral occlusion: results and problems.
- Author
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Schild HH, Günther R, and Thelen M
- Subjects
- Aged, Female, Follow-Up Studies, Humans, Male, Pelvic Neoplasms complications, Time Factors, Urinary Fistula epidemiology, Urinary Fistula etiology, Catheterization, Embolization, Therapeutic, Tissue Adhesives, Ureter, Urinary Diversion methods, Urinary Fistula therapy
- Abstract
Purpose: The effectiveness of transrenal ureteral occlusion was evaluated., Patients and Methods: Transrenal ureteral occlusions were performed in 83 ureters of 76 patients. Thirty-one ureters were occluded with use of tissue adhesive, which was secured in place with Gianturco coils in 21. Fifty-two ureters were occluded by means of silicone-filled, detachable latex balloons. Average follow-up was 3.6 months (range, 1 week to 38 months) for patients treated with the tissue adhesive and 7.9 months (range, 1 week to 61 months) for patients treated with the detachable balloons., Results: Seventeen (55%) of the 31 ureters occluded with tissue adhesive and 36 (69%) of the 52 ureters occluded with detachable balloons were permanently sealed after a single procedure. In 30 ureters, the occlusion procedure had to be repeated. The average duration of temporarily effective occlusions was 2.5 weeks when tissue adhesive was used and 19.5 weeks with detachable balloons. Complications were observed in 10 (7%) of 138 interventions. Only four of these were considered significant: two perforations occurred at the ureteropelvic junction, septicemia was seen after one procedure, and damage to a small intrarenal artery necessitated selective embolization in one patient., Conclusions: In selected patients, transrenal ureteral occlusion can effectively and safely interrupt urinary flow toward the bladder. Detachable balloons were superior to tissue adhesive as an occluding agent. more...
- Published
- 1994
- Full Text
- View/download PDF
234. Ureteral stents: exchange under fluoroscopic control as an effective alternative to cystoscopy.
- Author
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de Baere T, Denys A, Pappas P, Challier E, and Roche A
- Subjects
- Adult, Aged, Aged, 80 and over, Cystoscopy, Female, Fluoroscopy, Humans, Male, Middle Aged, Radiology, Interventional methods, Ureter, Stents, Ureteral Diseases therapy, Ureteral Obstruction therapy, Urinary Fistula therapy
- Abstract
From September 1991 to February 1993, in 83 patients (74 women and nine men, aged 24-86 years), 166 double-J ureteral stents (initially placed to treat fistulas or stenoses located within the inferior third of the ureter) were exchanged during 127 procedures. Stents were extracted from the bladder through the urethra under fluoroscopic monitoring by using a lasso made of a 0.018-inch guide wire and a 7-F catheter. Then a new stent was placed over a 0.035-inch guide wire that had been previously coiled in the renal pelvis. Exchange was successful in 161 (97%) of 165 stents. more...
- Published
- 1994
- Full Text
- View/download PDF
235. [Interventional procedures in the upper urinary tract].
- Author
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Ferro C and Castaneda-Zuniga W
- Subjects
- Embolization, Therapeutic, Humans, Prostheses and Implants, Ureteral Obstruction therapy, Urinary Fistula therapy, Nephrostomy, Percutaneous adverse effects, Nephrostomy, Percutaneous methods, Ureteral Diseases therapy
- Published
- 1994
236. Surgical complications in kidney transplantation.
- Author
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Benoit G, Blanchet P, Moukarzel M, Hiesse C, Bensadoun H, Bellamy J, Charpentier B, and Jardin A
- Subjects
- Angioplasty, Balloon, Humans, Kidney Transplantation methods, Postoperative Complications surgery, Postoperative Complications therapy, Renal Artery Obstruction etiology, Renal Artery Obstruction therapy, Ureteral Obstruction etiology, Ureteral Obstruction therapy, Urinary Fistula etiology, Urinary Fistula therapy, Urologic Diseases etiology, Urologic Diseases therapy, Kidney Transplantation adverse effects, Postoperative Complications etiology
- Published
- 1994
237. [Interventional radiological treatment in a patient with membranous urethral stenosis and perineal urethro-cutaneous fistulae].
- Author
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Antico E, Candelari R, Ulisse S, Mantovani P, Occhialini G, and Polito M Jr
- Subjects
- Aged, Catheterization, Constriction, Pathologic diagnostic imaging, Constriction, Pathologic therapy, Embolization, Therapeutic instrumentation, Humans, Male, Perineum, Skin Diseases therapy, Urethral Diseases therapy, Urinary Fistula therapy, Radiography, Interventional, Skin Diseases diagnostic imaging, Urethra diagnostic imaging, Urethral Diseases diagnostic imaging, Urinary Fistula diagnostic imaging
- Published
- 1994
238. Ureteric injuries during gynaecological surgery.
- Author
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Sharfi AR and Ibrahim F
- Subjects
- Adult, Cystoscopy, Female, Follow-Up Studies, Humans, Middle Aged, Reoperation, Surgical Procedures, Operative methods, Ureteral Diseases diagnosis, Urinary Catheterization, Urinary Fistula diagnosis, Urinary Fistula therapy, Vaginal Fistula diagnosis, Vaginal Fistula therapy, Genital Diseases, Female surgery, Intraoperative Complications, Ureter injuries, Ureteral Diseases therapy
- Abstract
Thirty-two patients with 35 ureteric injuries encountered during gynaecological surgery are presented. Their mean age was 41 years. Eight ureteric injuries were recognized during surgery, the nature and sites of injury were diagnosed peroperatively using an illuminated size 5 F ureteric probe (Storz) passed through a cystoscope. Three ureteric injuries were diagnosed during convalescence as continuous drainage of urine or urinoma collection, while three patients developed total anuria due to ligation of both ureters. Eighteen patients presented with late urinary fistulae, being uretero-uterine in 8 and ureterovaginal in 10. The ureteric injury occurred during emergency Caesarean section in 15 patients, the indication for Caesarean section being obstructed prolonged labour in 70% of them. Twelve urinary fistulae followed hysterectomy. Intravenous urography, antegrade and retrograde ureterography were useful methods of locating the sites of the fistulae. Ureteroneocystostomy was performed in 18 patients, utilizing a Boari flap in 3 and a bladder psoas hitch in 2. Other methods of treatment are discussed. The mean follow-up was 3 years. more...
- Published
- 1994
- Full Text
- View/download PDF
239. [Uretero-uterine fistula. Diagnostic and therapeutic management].
- Author
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Pernin F, Fanton Y, and Dufour B
- Subjects
- Adult, Cesarean Section adverse effects, Cystoscopy, Female, Fistula etiology, Fistula prevention & control, Humans, Pregnancy, Replantation, Ureteral Diseases etiology, Ureteral Diseases prevention & control, Urinary Diversion, Urinary Fistula etiology, Urinary Fistula prevention & control, Urinary Incontinence etiology, Urography, Uterine Diseases etiology, Uterine Diseases prevention & control, Fistula diagnosis, Fistula therapy, Ureteral Diseases diagnosis, Ureteral Diseases therapy, Urinary Fistula diagnosis, Urinary Fistula therapy, Uterine Diseases diagnosis, Uterine Diseases therapy
- Abstract
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. more...
- Published
- 1993
240. Urological complications of renal transplantation.
- Author
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Rosenthal JT
- Subjects
- Anastomosis, Surgical, Humans, Kidney Pelvis surgery, Nephrostomy, Percutaneous, Stents, Ureteral Diseases etiology, Ureteral Diseases therapy, Urinary Bladder surgery, Urinary Fistula etiology, Urinary Fistula therapy, Kidney Transplantation adverse effects
- Published
- 1993
- Full Text
- View/download PDF
241. Percutaneous management of transplant ureteral fistulas: patient selection and long-term results.
- Author
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Campbell SC, Streem SB, Zelch M, Hodge E, and Novick AC
- Subjects
- Follow-Up Studies, Humans, Time Factors, Treatment Outcome, Ureteral Diseases epidemiology, Ureteral Diseases etiology, Urinary Fistula epidemiology, Urinary Fistula etiology, Kidney Transplantation adverse effects, Nephrostomy, Percutaneous, Stents, Ureteral Diseases therapy, Urinary Fistula therapy
- Abstract
Of 24 renal allograft recipients with urinary extravasation 14 (58%) with ureteral fistulas were selected for percutaneous management in an attempt to obviate secondary operative intervention. The initial procedure in all cases was placement of a percutaneous nephrostomy tube with subsequent internal or internal/external stenting. With a mean followup of 47 months, the percutaneous management proved definitive in 5 patients (36%) and palliative in 1 (7%). The other 8 patients (57%) subsequently required open operative intervention. With this study, we conclude that percutaneous techniques can provide long-term definitive management for at least some transplant ureteral fistulas. However, even in a highly selected group of patients success rates will be limited. more...
- Published
- 1993
- Full Text
- View/download PDF
242. Rectal injury occurring at radical retropubic prostatectomy for prostate cancer: etiology and treatment.
- Author
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McLaren RH, Barrett DM, and Zincke H
- Subjects
- Aged, Biopsy, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Staging, Preoperative Care, Prostatic Neoplasms pathology, Prostatic Neoplasms radiotherapy, Rectal Fistula etiology, Rectal Fistula therapy, Urinary Fistula etiology, Urinary Fistula therapy, Intraoperative Complications epidemiology, Intraoperative Complications etiology, Intraoperative Complications therapy, Prostatectomy methods, Prostatic Neoplasms surgery, Rectum injuries
- Abstract
Of 2,212 patients who underwent radical retropubic prostatectomy for the treatment of prostate cancer, 27 had documented rectal injuries. All but one were detected immediately at the time of surgery and were repaired; a temporary diverting colostomy was established in 6 patients. Follow-up on these patients ranged from nine to one hundred eighty-five months (mean, 68 months). Four patients had fistulas between the rectum and the urinary tract that required additional surgery. Factors that predisposed patients for intraoperative injury to the rectum include a history of previous pelvic radiation therapy, previous rectal surgery, and previous transurethral resection of the prostate (P < 0.01). Higher local tumor stage did not significantly increase the risk of rectal injury at the time of radical retropubic prostatectomy. Preoperative bowel preparation may obviate colostomy; it may still be necessary in high-risk patients with suboptimal local repair. more...
- Published
- 1993
- Full Text
- View/download PDF
243. Ureteroarterial fistulae in exenteration patients with indwelling ureteral stents.
- Author
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Gelder MS, Alvarez RD, and Partridge EE
- Subjects
- Adult, Angiography, Angioplasty, Balloon, Female, Fistula diagnostic imaging, Fistula therapy, Humans, Middle Aged, Pelvic Exenteration, Ureteral Diseases diagnostic imaging, Ureteral Diseases therapy, Urinary Fistula diagnostic imaging, Urinary Fistula therapy, Fistula etiology, Iliac Artery diagnostic imaging, Stents adverse effects, Ureteral Diseases etiology, Urinary Fistula etiology
- Abstract
Ureteroarterial fistulae (UAF) are a rare complication of prolonged ureteral stenting. To date only three patients have been reported who have developed UAF after pelvic exenteration. This report presents two additional patients with UAF following exenteration and prolonged ureteral stenting. Rapid diagnosis with pelvic arteriography and retrograde ureteral angioplasty balloon catheter placement is discussed, and successful management with femoral artery embolization and bypass surgery is reviewed. more...
- Published
- 1993
- Full Text
- View/download PDF
244. Endourological treatment of ureteric injuries.
- Author
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Cormio L, Battaglia M, Traficante A, and Selvaggi FP
- Subjects
- Cutaneous Fistula etiology, Cutaneous Fistula therapy, Endoscopy, Female, Humans, Male, Stents, Ureteral Diseases etiology, Ureteral Diseases therapy, Ureteral Obstruction etiology, Ureteral Obstruction therapy, Urinary Fistula etiology, Urinary Fistula therapy, Postoperative Complications therapy, Ureter injuries
- Abstract
Over the last 8 years, 30 patients with ureteric injuries underwent endoscopic treatment. There were 14 failures, 5 because of blockage or diversion of the catheter in the fistulous gap and 9 because it was impossible to penetrate the stenotic tract. All failures occurred when treatment was attempted more than 3 weeks after the trauma. Sixteen lesions were successfully treated by placing a 6 to 10 F double pigtail catheter in the damaged ureter and leaving it for at least 3 months. Patients were followed up for 24 months. No recurrences were seen and good long-term results were achieved in all cases. In our experience, endourological treatment can be recommended for recent strictures < 2 cm in length, or for small fistulas in which continuity of the ureteric wall is still partially preserved. Despite the risk of failure, especially following late treatment of an injury, it should be considered a safe and effective procedure that is accepted well by the patients and that avoids the need for open surgery and its possible complications. more...
- Published
- 1993
- Full Text
- View/download PDF
245. [The therapeutic approach in vascular damage from pyelocaliceal endoscopic urology].
- Author
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Fernández González I, Serrano Pascual AV, Burgos Revilla J, García Cuerpo E, Berenguer Sánchez A, and Lovaco Castellano F
- Subjects
- Arteriovenous Fistula etiology, Arteriovenous Fistula therapy, Embolization, Therapeutic, Female, Humans, Intraoperative Complications etiology, Kidney Calculi complications, Kidney Calculi surgery, Kidney Diseases etiology, Kidney Diseases therapy, Male, Middle Aged, Nephrectomy, Urinary Fistula etiology, Urinary Fistula therapy, Intraoperative Complications therapy, Kidney Calices surgery, Kidney Pelvis surgery, Nephrostomy, Percutaneous adverse effects, Renal Artery injuries, Renal Veins injuries
- Abstract
Six cases of vascular lesion associated with percutaneous removal of renal calculi are described. The lesions had been caused during percutaneous access or ultrasound fragmentation of the stone. Those that had resolved spontaneously have not been included. When vascular injury is suspected during the procedure, the appropriate measures must be taken to resolve the different complications, such as arteriovenous, arteriocaliceal or venocaliceal fistula. Since there is little reference to this subject in the Spanish literature, the experience described herein may be of interest to the urologist who has only recently begun to perform this technique. more...
- Published
- 1993
246. Urethrospongiosal fistulas: clinical and therapeutic considerations.
- Author
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Destito A, Racioppi M, Sasso F, D'Addessi A, Gulino G, and Alcini E
- Subjects
- Aged, Humans, Male, Middle Aged, Radiography, Urinary Catheterization adverse effects, Fistula diagnostic imaging, Fistula etiology, Fistula therapy, Penile Diseases diagnostic imaging, Penile Diseases etiology, Penile Diseases therapy, Urethral Diseases diagnostic imaging, Urethral Diseases etiology, Urethral Diseases therapy, Urinary Fistula diagnostic imaging, Urinary Fistula etiology, Urinary Fistula therapy
- Abstract
From 1986 to 1990, 8 cases of urethrospongiosal fistulas were observed. All the patients had a history of bleeding after a difficult catheterization. The symptoms were not pathognomonic but the fistulas were visible only by X-ray examination. The authors suggest that urethrospongiosal fistulas are more common than one expects, especially in cases of bleeding after complicated catheterization. This is more frequent when coexistent urethral strictures or prostatic hypertrophy make the maneuver difficult. The authors also suggest that the urinary extravasation in the corpus spongiosum could explain the pathophysiology of the urethral manipulation syndrome according to Kelamy. more...
- Published
- 1993
- Full Text
- View/download PDF
247. Re: Balloon ureteral occlusion: a new reversible technique in the management of ureteral fistulas.
- Author
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Fraser KS and Baga M
- Subjects
- Humans, Male, Urinary Catheterization, Urinary Diversion, Ureteral Diseases therapy, Urinary Fistula therapy
- Published
- 1992
248. [Conservative treatment of ureteral iatrogenesis of gynecologic origin].
- Author
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Gómez Vegas A, Silmi Moyano A, Blázquez Izquierdo J, Páramo González P, Corral Rosillo J, Delgado Martín JA, Gómez Ruiz JJ, and Resel Estévez L
- Subjects
- Female, Follow-Up Studies, Humans, Middle Aged, Radiography, Ureteral Diseases diagnostic imaging, Ureteral Diseases etiology, Ureteral Obstruction diagnostic imaging, Ureteral Obstruction etiology, Urinary Fistula diagnostic imaging, Urinary Fistula etiology, Vaginal Fistula diagnostic imaging, Vaginal Fistula etiology, Hysterectomy adverse effects, Ureteral Diseases therapy, Ureteral Obstruction therapy, Urinary Fistula therapy, Vaginal Fistula therapy
- Abstract
Five patients with iatrogenic ureteral injuries are described herein. Two patients had a vesicoureteric fistula and the remaining three patients had obstructive uropathy secondary to ligation with resorbable material during hysterectomy for a benign uterine condition, which spontaneously resolved with conservative management. Classically, the approach of this type of lesion was interventional and careful patient selection afforded the possibility of definitive resolution. US, CT and modern endourological technology have facilitated temporary diversion via percutaneous nephrostomy (or surgery, if the foregoing is not possible) to protect renal function during the process of recanalization of the injured ureter. Furthermore, it permits radiological control of the course and functional assessment of the excretory tract. more...
- Published
- 1992
249. Renal artery embolization with ethanol and gelfoam for the treatment of ureteric fistulae with one year follow-up.
- Author
-
Long MA and McIvor J
- Subjects
- Female, Follow-Up Studies, Humans, Middle Aged, Postoperative Complications diagnostic imaging, Postoperative Complications therapy, Radiography, Renal Artery diagnostic imaging, Ureteral Diseases diagnostic imaging, Urinary Fistula diagnostic imaging, Embolization, Therapeutic methods, Ethanol therapeutic use, Gelatin Sponge, Absorbable, Ureteral Diseases therapy, Urinary Fistula therapy
- Abstract
Two patients with ureteric fistulae who were unfit for reconstructive surgery were treated by renal ablation using intra-arterial ethanol, gelfoam fragments and in one case coils. In both cases the fistulae dried-up on the same day and both patients are well and normotensive a year later. Our conclusion is that renal ablation by arterial embolization with ethanol can be a valuable alternative to surgery to treat ureteric fistulae in patients who are poor surgical risks. more...
- Published
- 1992
- Full Text
- View/download PDF
250. [Ureteral tamponade in the treatment of urinary fistula: our experience].
- Author
-
García-Matres Cortes MJ, Cárcamo Valor PI, Cózar Olmo JM, San Millán Arruti JP, Hidalgo Togores L, and Martínez-Piñeiro JA
- Subjects
- Aged, Female, Humans, Male, Ureter, Tampons, Surgical, Urinary Fistula therapy
- Abstract
Surgical correction is the treatment of choice for urinary fistulas. However, there are circumstances that advise against the use of this approach, basically when patient general condition is poor or life expectancy short; i. e., in the presence of an underlying malignant pelvic disease. In these cases, urinary diversion by percutaneous nephrostomy will suffice, although sepsis or derangement of electrolyte balance may sometimes develop due to the fistulous defect. Occlusion of the pyelo-ureteric junction and percutaneous drainage is a solution that causes no major complications. Two patients who could not be submitted to conventional surgery were treated by the foregoing procedure. Both patients have been followed for more than two years. The first case was a male who had undergone abdominoperineal resection due to carcinoma of the sigmoid colon. He developed stress ulcers, pulmonary thromboembolism, sepsis, paralytic ileus and bilateral ureteral fistula. The second case was an insulin-dependent female diabetic who had previously received radiotherapy to the pelvis. She developed a large vesicocutaneous fistula and public osteomyelitis after drainage of an inguinal abscess. Patient tolerance was good and no major complications were observed. In our view this palliative procedure should be considered in the management of patients with urinary fistula whose life expectancy is short. Its application can be extended to patients with inoperable carcinoma of the bladder or prostate and important symptoms. more...
- Published
- 1992
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