INTRODUCTION: To describe an original method for managing prolonged urinary leakage after partial nephrectomy.
We placed a Malecot catheter in the ureter to improve the urinary drainage and therefore avoid the renal percutaneous treatment of the fistula or potential open surgery.
TECHNICAL CONSIDERATIONS: We performed ureteral stenting using a 16F Malecot catheter in 3 patients who had a prolonged urinary fistula after partial nephrectomy in which the placement of a ureteral stent could not resolve the urine leak. Drainage using 2 ureteral catheters was performed, which proved to be insufficient for the urinary fistula to resolve. We subsequently placed in the dilated ureter a 16F Malecot catheter into the renal pelvis using a cystoscopic approach and a bladder catheter to complete the drainage. In all cases, the urine leak stopped after stenting with the Malecot catheter. At 1 month after the stenting, computed tomography and magnetic resonance imaging showed complete healing of the fistula. No infection or secondary ureteral stricture was reported.
CONCLUSION: This technique with a low complication profile can be used as an additional endoscopic step, before more invasive procedures.
Written by:
Girard F, Thanigasalam R, Theveniaud PE, El Hajj A, Eimer C, Sibileau E, Massoud W, Fennouri M, Baumert H. Are you the author?
Department of Urology, Groupe Hospitalier Paris Saint Joseph, Paris, France.
Reference: Urology. 2013 Nov 11. pii: S0090-4295(13)01158-8.
doi: 10.1016/j.urology.2013.09.006
PubMed Abstract
PMID: 24231211
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