[Ureteral tamponade in the treatment of urinary fistula: our experience].
Surgical correction is the treatment of choice for urinary fistulas. However, there are circumstances that advise against the use of this approach, basically when patient general condition is poor or life expectancy short; i. e., in the presence of an underlying malignant pelvic disease. In these cases, urinary diversion by percutaneous nephrostomy will suffice, although sepsis or derangement of electrolyte balance may sometimes develop due to the fistulous defect. Occlusion of the pyelo-ureteric junction and percutaneous drainage is a solution that causes no major complications. Two patients who could not be submitted to conventional surgery were treated by the foregoing procedure. Both patients have been followed for more than two years. The first case was a male who had undergone abdominoperineal resection due to carcinoma of the sigmoid colon. He developed stress ulcers, pulmonary thromboembolism, sepsis, paralytic ileus and bilateral ureteral fistula. The second case was an insulin-dependent female diabetic who had previously received radiotherapy to the pelvis. She developed a large vesicocutaneous fistula and public osteomyelitis after drainage of an inguinal abscess. Patient tolerance was good and no major complications were observed. In our view this palliative procedure should be considered in the management of patients with urinary fistula whose life expectancy is short. Its application can be extended to patients with inoperable carcinoma of the bladder or prostate and important symptoms.
García-Matres Cortes
M J
MJ
Servicio de Urología, Hospital La Paz, Facultad de Medicina, Universidad Autónoma, Madrid, España.
Cárcamo Valor
P I
PI
Cózar Olmo
J M
JM
San Millán Arruti
J P
JP
Hidalgo Togores
L
L
Martínez-Piñeiro
J A
JA
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D013630:Tampons, Surgical; D014513:Ureter; D014548:Urinary Fistula / Q000628:therapy*
Taponamiento ureteral en el tratamiento de las fístulas urinarias: nuestra experiencia.