Successful Closure of Persistent Urinary Fistula After High-Grade Renal Trauma Using N-Butyl-2-Cyanoacrylate: A Case
Yui Yamauchi1, Masataka Kawamura1, Yuji Koretsune2
1Department of Urology The University of Osaka Graduate School of Medicine Osaka Japan.
Introduction:
Persistent urinary extravasation after high-grade renal trauma is uncommon but may require intervention. Minimally invasive, kidney-preserving options are particularly desirable in young patients.
Case Presentation:
An 18-year-old man sustained blunt trauma in a motorcycle accident. Contrast-enhanced computed tomography revealed renal injury with urinary extravasation. Emergency transcatheter arterial embolization was performed for hemorrhage control. Despite subsequent ureteral stenting and percutaneous drainage, urinary leakage persisted. Fistulography demonstrated a small fistulous tract between the urinoma cavity and the lower calyx. Selective embolization using N-butyl-2-cyanoacrylate (NBCA) was performed, resulting in immediate resolution without complications.
Conclusion:
Selective NBCA embolization is a safe and minimally invasive treatment option for persistent urinary fistula after renal trauma.
