[Percutaneous Fibrin Glue Injection for Persistent Urinary Leakage after Partial Nephrectomy : A Case Report]

Area of Science:

• Urology
• Surgical Oncology
• Radiology

Background:

• Partial nephrectomy is a standard treatment for localized renal tumors.
• Postoperative complications, such as urinary fistulas and urinomas, can occur.
• Management of large urinomas can be challenging.

Observation:

• A 69-year-old man developed a 16 cm retroperitoneal urinoma due to urinary leakage from a partial nephrectomy scar.
• Initial percutaneous drainage and stent placement failed to resolve the significant daily urinary discharge (700-1000 ml/day).

Findings:

• A novel approach involved percutaneous insertion of two catheters into the urinary fistula.
• Injection of fibrin glue (6 ml initially, then 2 ml) via these catheters successfully sealed the fistula.
• Complete resolution of urinary leakage was achieved, allowing for removal of drainage catheters and stents.

Implications:

• Fibrin glue injection represents a viable and effective minimally invasive treatment for refractory post-nephrectomy urinomas.
• This technique may offer an alternative to more invasive surgical re-exploration.
• Successful fistula closure can improve patient recovery and reduce hospital stay.