Ta. Farrell et al., LONG-TERM RESULTS OF TRANSRENAL URETERAL OCCLUSION WITH USE OF GIANTURCO COILS AND GELATIN SPONGE PLEDGETS, Journal of vascular and interventional radiology, 8(3), 1997, pp. 449-452
PURPOSE: To evaluate transrenal ureteral occlusion with Gianturco coil
s and gelatin sponge pledgets. MATERIALS AND METHODS: The authors revi
ewed 34 ureteral occlusions in 22 patients during a 4-year period. The
indications for this procedure included vesicovasnal fistula in 11 pa
tients and urinary incontinence in three patients. All patients except
one had a history of pelvic malignancy and previous radiation therapy
. Pre-existing percutaneous nephrostomy tubes were in place in 20 uret
ers to be embolized. Distal ureteral occlusion was achieved by placeme
nt of Gianturco coils alone or in combination with gelatin sponge pled
gets. A percutaneous nephrostomy catheter was then placed to provide p
ermanent external diversion. Follow-up ranged from 2 weeks to 29 month
s (mean, 6.2 months). RESULTS: Occlusion was technically successful in
all embolized ureters. All patients experienced prompt resolution of
symptoms as indicated by complete or near complete perineal dryness wi
thin 72 hours. Complications were limited to coil migration into the r
enal pelvis in two patients and nephrostomy catheter occlusion requiri
ng replacement in another three patients. CONCLUSION: Ureteral occlusi
on with Gianturco coils and gelatin sponge is a safe and reliable meth
od of achieving permanent supravesical urinary diversion in the manage
ment of chronic lower urinary tract fistulas.