[Experience with transrenal ureteral occlusion (author's transl)]

Area of Science:

• Urology
• Interventional Radiology
• Oncology

Background:

• Urinary incontinence poses a significant challenge in patients with advanced pelvic malignancies and post-radiation complications.
• Previous management often involves complex surgical interventions or urinary diversion, with limited success in achieving dryness.
• Palliative management strategies are crucial for improving quality of life in these challenging cases.

Observation:

• Butyl-2-cyano-acrylate and lipiodol mixture was used for ureteral embolization in four patients with refractory urinary incontinence.
• Access methods included transurethral and transrenal approaches, with one instance of embolic material dislocation without sequelae.
• Adjuvant balloon catheter occlusion was utilized in the transrenal approach, preventing complications.

Findings:

• Successful palliative management of urinary incontinence was achieved in all four patients, with complete dryness reported post-procedure.
• Two patients required a second ureteral embolization to achieve the desired outcome.
• No complications were encountered with the transrenal access technique.

Implications:

• Ureteral embolization presents a viable, minimally invasive option for palliative urinary incontinence management in complex oncological cases.
• This technique can significantly improve patient quality of life by achieving complete continence.
• Further research into optimizing access and embolic agents may enhance outcomes and reduce the need for repeat procedures.