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Fluoroscopically guided pyeloureteral interventions by using a perurethral transvesical approach
M A Amendola1, M P Banner, H M Pollack
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
AJR. American Journal of Roentgenology
|January 1, 1989
Summary
The perurethral transvesical approach is a safe and effective method for various pyeloureteral interventions, achieving a 93% success rate with minimal complications. This technique offers a less invasive alternative to traditional surgical methods.
Area of Science:
- Urology
- Interventional Radiology
Background:
- The perurethral transvesical approach is an established technique for accessing the upper urinary tract.
- Minimally invasive interventions are increasingly preferred over traditional surgical procedures.
Purpose of the Study:
- To evaluate the efficacy and safety of the perurethral transvesical approach for a wide range of pyeloureteral uroradiologic interventional procedures.
- To assess the success rate and complication profile of this method.
Main Methods:
- A total of 180 perurethral transvesical procedures were attempted over 20 months.
- Standard interventional equipment, fluoroscopy, and ureteral catheters were utilized.
- Procedures included stent insertion, catheter advancement, urothelial biopsy, stricture dilatation, and stone extraction.
Main Results:
- 168 procedures (93% success rate) were successfully completed.
- Commonly performed procedures included double-pigtail stent insertion (42) and single-pigtail stent insertion (47).
- Complications occurred in 5% of cases, including urosepsis and ureteral perforations, all managed conservatively.
Conclusions:
- The perurethral transvesical approach is a simple, safe, and expeditious method for diverse pyeloureteral interventions.
- This technique frequently obviates the need for more invasive procedures like percutaneous nephrostomy or ureteroscopy.
- The approach is valuable beyond its use as an adjunct to lithotripsy.