title: Long-term results of transrenal ureteral occlusion with use of Gianturco coils and gelatin sponge pledgets.
abstract: OBJECTIVE
  To evaluate transrenal ureteral occlusion with Gianturco coils and gelatin sponge pledgets.
  
  
  METHODS
  The authors reviewed 34 ureteral occlusions in 22 patients during a 4-year period. The indications for this procedure included vesicovaginal fistula in 11 patients and urinary incontinence in three patients. All patients except one had a history of pelvic malignancy and previous radiation therapy. Pre-existing percutaneous nephrostomy tubes were in place in 20 ureters to be embolized. Distal ureteral occlusion was achieved by placement of Gianturco coils alone or in combination with gelatin sponge pledgets. A percutaneous nephrostomy catheter was then placed to provide permanent external diversion. Follow-up ranged from 2 weeks to 29 months (mean, 6.2 months).
  
  
  RESULTS
  Occlusion was technically successful in all embolized ureters. All patients experienced prompt resolution of symptoms as indicated by complete or near complete perineal dryness within 72 hours. Complications were limited to coil migration into the renal pelvis in two patients and nephrostomy catheter occlusion requiring replacement in another three patients.
  
  
  CONCLUSIONS
  Ureteral occlusion with Gianturco coils and gelatin sponge is a safe and reliable method of achieving permanent supravesical urinary diversion in the management of chronic lower urinary tract fistulas.
authors.affiliation: Mallinckrodt Institute of Radiology, St. Louis, Mo, USA.
authors.forename: T A
authors.initials: TA
authors.lastname: Farrell
authors.forename: M
authors.initials: M
authors.lastname: Wallace
authors.forename: M E
authors.initials: ME
authors.lastname: Hicks
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D019736:Prostheses and Implants; D013997:Time Factors; D016896:Treatment Outcome; D014513:Ureter; D014547:Urinary Diversion / Q000379:methods; D014549:Urinary Incontinence / Q000628:therapy*; D014719:Vesicovaginal Fistula / Q000628:therapy*