Percutaneous management of ureteral fistulas

Ureteral occlusion with proximal urinary diversion is often required when treating patients with ureteral fistulas secondary to advanced neoplastic disease. Recent endourologic advancements have stemmed from the high morbidity and mortality associated with formal surgical reconstruction in this population. Endourologic management may be accomplished by a transrenal or retroperitoneal approach. To date, no study has clearly demonstrated the superiority of any one approach because of the small numbers of patients and the uniformly short-term follow-up.