Persistent urinary leak after partial nephrectomy in a child: Definitive therapy with percutaneous glue

Area of Science:

• Urology
• Interventional Radiology
• Pediatric Surgery

Background:

• Urinary fistulas often require surgical intervention, with nephrectomy considered for persistent cases.
• Percutaneous glue embolization has been reported as an alternative to nephrectomy in adults with refractory urinary fistulas.
• Pediatric urinary fistulas, especially post-nephrectomy, present unique management challenges.

Observation:

• A child with a persistent urinary leak post-partial nephrectomy for recurrent microabscesses was treated.
• The treatment involved a percutaneous approach using cyanoacrylate glue and a vascular occlusion plug.
• This minimally invasive technique aimed to avoid a nephrectomy in the pediatric patient.

Findings:

• Successful percutaneous treatment of a pediatric urinary fistula was achieved.
• The combined use of cyanoacrylate glue and a vascular occlusion plug proved effective.
• This represents the first reported case of percutaneous glue treatment with an adjunct vascular occlusion device for a urinary leak in a child.

Implications:

• This technique offers a potential nephron-sparing alternative for pediatric urinary fistulas.
• It expands the application of percutaneous interventions in pediatric urological conditions.
• Further research may validate this approach for similar pediatric cases, reducing the need for major surgery.