Management of urinary-tract fistulas using reversible balloon nephrostomy: a single-center retrospective analysis of 56 patients

To evaluate the effectiveness of balloon nephrostomy (BN) for treating urinary tract fistulas.

In a single-center retrospective analysis, 56 patients were treated using BN between 2003 and 2014. All causes of urinary tract fistula were included. We assessed the effectiveness of drainage, complications, and the types of reconstruction surgery used. Success was defined as fistula closure without surgery.

The cohort consisted of 25 males (54%) and 31 females (55%) with a median age of 63 years who underwent BN for a urinary fistula secondary to surgery, i.e., urologic (40%; n = 22), gynecologic (34%; n = 19), or digestive (20%; n = 11). Of these patients, 48 (86%) had a history of cancer (49% had a tumor progression). Median drainage time was 90 days (10-583), with an average of three successive readjustments needed per patient. We obtained a 21% success rate (n = 12), morbidity was 6.5% (urinary sepsis, renal abscess, ureteral stricture), and 7% of patients developed ureteral stricture after balloon removal. There was no recurrence of any fistula within a median follow-up time of 15.2 months.

This minimally invasive procedure can be used for selected urinary tract fistulas with few complications. It can also be used safely in populations that have several comorbidities.

International urogynecology journal. 2018 Mar 15 [Epub ahead of print]

Jérôme Gas, François-Xavier Nouhaud, Mathieu Roumiguié, Séverine Lagarde, Marie-Charlotte Delchier, Éric Huyghe, Michel Soulié, Xavier Gamé, Jean-Baptiste Beauval

Department of Urology, Andrology and Kidney Transplantation, CHU Toulouse, Toulouse, 31059, France. ., Department of Urology, Andrology and Kidney Transplantation, CHU Toulouse, Toulouse, 31059, France., Department of Radiology, CHU Toulouse, Toulouse, 31059, France.

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