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Anastomosed ureters: fluoroscopically guided transconduit retrograde catheterization.
M P Banner1, M A Amendola, H M Pollack
1Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia 19104.
Radiology
|January 1, 1989
Summary
Retrograde ureteral catheterization through a bowel conduit is a feasible alternative to percutaneous nephrostomy (PCN) for renal drainage and stent exchange in select patients. This minimally invasive approach avoids complications and offers effective management for ureteral strictures and calculi.
Area of Science:
- Urology
- Interventional Radiology
Background:
- Ureteral diversion to a bowel conduit presents challenges for accessing the ureter and kidney.
- Percutaneous nephrostomy (PCN) is often required for renal drainage in these patients.
- Alternative minimally invasive techniques are needed to avoid PCN.
Purpose of the Study:
- To evaluate the feasibility and efficacy of fluoroscopically guided, transconduit retrograde ureteral catheterization.
- To determine if this retrograde approach can obviate the need for PCN.
Main Methods:
- Retrospective review of 14 attempted transconduit retrograde ureteral catheterizations.
- Use of standard angiographic equipment and Teflon sheaths in the bowel conduit.
- Indications included renal drainage, stone removal, and stent exchange.
Main Results:
- Successful retrograde catheterization in 12 out of 14 cases (86%).
- PCN was obviated in 11 cases for conditions like ureteral strictures, renal calculi, and stent exchange.
- Facilitated subsequent PCN in one obese patient with calyceal calculi.
- No complications were encountered.
Conclusions:
- Transconduit retrograde ureteral catheterization is a safe and effective alternative to PCN in patients with ureteroenteral anastomoses.
- This technique provides a valuable option for renal drainage and management of ureteral issues in diverted systems.