Percutaneous ureteral clipping: long-term results and complications.
OBJECTIVE
The authors present their experience with ureteral clipping in patients with urinary fistulas.


METHODS
The authors retrospectively reviewed records from eight patients in whom 14 ureters were ligated with use of a percutaneously applied stainless steel clip as treatment for urinary fistulas. All patients were female and had undergone pelvic radiation for treatment of cervical carcinoma (n = 7) or endometrial carcinoma (n = 1). Permanent urinary diversion was via percutaneous nephrostomy, which required routine change, at which time recurrence of symptoms and ureteral leakage were determined. Duration of follow-up (patient survival) ranged from 2 weeks to 17 months (mean, 7.1 months).


RESULTS
All patients had significant improvement in their symptoms, with seven patients achieving complete perineal dryness. Two patients had recurrence of perineal symptoms due to nephrostomy tube blockage, which was successfully managed by means of interventional techniques.


CONCLUSIONS
The authors believe that ureteral clipping is a safe and effective technique in the management of ureteral fistulas due to pelvic neoplasm and its treatment, despite the short life expectancy of these patients.
Farrell
T
T
Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
Yamaguchi
T
T
Barnhart
W
W
Lang
E
E
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000009:adverse effects / Q000295:instrumentation; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D011832:Radiation Injuries / Q000628:therapy; D012003:Rectal Fistula / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D014513:Ureter; D014515:Ureteral Diseases / Q000209:etiology / Q000628:therapy*; D001747:Urinary Bladder Fistula / Q000209:etiology / Q000628:therapy*; D014547:Urinary Diversion / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy; D014719:Vesicovaginal Fistula / Q000209:etiology / Q000628:therapy*