Retrograde catheterization of the ureter without cystoscopic assistance: preliminary experience

Standard angiographic techniques were applied to fluoroscopically directed retrograde guide wire or catheter placement into the distal ureter without cystoscopic assistance. The procedure was successful in five of the seven initial attempts, with no complications. Retrograde pyelography and stent placement were accomplished for a benign posttraumatic ureteral stricture, a proximal ureteral calculus, and three malignant ureteral strictures. Percutaneous nephrostomy was obviated in all successful cases. Fluoroscopy time averaged less than 3 minutes. Mild intravenous sedation was used, and the procedure was well tolerated. This initial experience suggests that this method may be useful for a variety of endourologic procedures, as well as for routine retrograde pyelography.