Transrenal ureteral embolization

Transrenal closure of the ureter with butyl-2-cyanoacrylate using adjuvant balloon catheter occlusion was successfully performed for the palliative management of inoperable vesicovaginal and vesicosacral fistulas in 3 patients. Unilateral percutaneous nephrostomy provided supravesical urinary diversion as well as access for permanent embolization of the ureter. The contralateral kidney was nonfunctional in 2 patients. In the third, in addition to unilateral ureteral occlusion, the contralateral kidney was defunctionalized by embolization of the renal artery ("radiological nephrectomy") to avoid the need for bilateral nephrostomy drainage.