Cyanoacrylic glue: a minimally invasive nonsurgical first line approach for the treatment of some urinary fistulas.
OBJECTIVE
We evaluated the adaptability and the efficacy of a cyanoacrylic glue for the conservative treatment of urinary fistulas of different etiologies using an endoscopic, percutaneous or endovaginal approach.


METHODS
From May 1998 to July 2004, 13 patients with long lasting iatrogenic and/or inflammatory urinary fistulas were treated conservatively with endoscopic, percutaneous or endovaginal application of 1 to 3 cc of cyanoacrylic glue.


RESULTS
The complication rate in this cohort of 13 patients was low. Occlusion therapy failed in 2 genitourinary fistulas which were wider (diameter greater than 1 cm) and short. In the remaining 11 cases urinary fistulas were successfully sealed and at a median followup of 35 months no relapses were observed.


CONCLUSIONS
Cyanoacrylic glue is suitable for endoscopic, percutaneous and endovaginal use. This occlusion therapy represents a safe and minimally invasive approach that might be offered as a first line option for the treatment of urinary fistulas, especially narrow and long tract fistulas.
Muto
Giovanni
G
Department of Urology, S. Giovanni Bosco Hospital, Piazza Donatori Sangue 3, 10154 Turin, Italy. g.muto@tin.it
D'Urso
Leonardo
L
Castelli
Emanuele
E
Formiconi
Andrea
A
Bardari
Franco
F
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003487:Cyanoacrylates / Q000627:therapeutic use*; D005260:Female; D052776:Female Urogenital Diseases / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D007077:Ileal Diseases / Q000628:therapy; D007669:Kidney Calculi / Q000628:therapy; D008297:Male; D052801:Male Urogenital Diseases; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011467:Prostate / Q000473:pathology; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome; D014521:Urethra / Q000473:pathology; D014548:Urinary Fistula / Q000628:therapy*; D014719:Vesicovaginal Fistula / Q000628:therapy
D003487:Cyanoacrylates; D014014:Tissue Adhesives; C040229:MK 6 cyanoacrylate