title: Management of a malignant urinary fistula by ureteral embolization with coils.
abstract: We report the case of a 42-year-old man with a synovial sarcoma of the prostate, metastatic at presentation, who after aggressive chemotherapy followed by extensive surgery developed a complex pelvic fistula involving the lower ureter, bladder, and enteral structures. The patient was a poor candidate for surgery because of his short life expectancy and poor health status. Conservative management with bilateral nephrostomy tubes did not allow sufficient fistulous output for symptomatic relief. Using the percutaneous access already in place, we performed bilateral ureteral embolization with coils. Complete ureteral occlusion was obtained with a minimally invasive procedure and allowed total symptomatic relief.
authors.affiliation: Department of Urology, Hôpital Cochin, Paris, France. d.amsellem-ouazana@cch.aphp.fr
authors.forename: Delphine
authors.initials: D
authors.lastname: Amsellem-Ouazana
authors.forename: François
authors.initials: F
authors.lastname: Cornud
authors.forename: Sophie
authors.initials: S
authors.lastname: Conquy
authors.forename: Philippe
authors.initials: P
authors.lastname: Beuzeboc
authors.forename: Pierre Philippe
authors.initials: PP
authors.lastname: Massault
authors.forename: Annick
authors.initials: A
authors.lastname: Vieillefond
authors.forename: Thierry
authors.initials: T
authors.lastname: Flam
authors.forename: Marc
authors.initials: M
authors.lastname: Zerbib
authors.forename: Bernard
authors.initials: B
authors.lastname: Debré
mesh_terms: D000328:Adult; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D006801:Humans; D007412:Intestinal Fistula / Q000628:therapy*; D008297:Male; D011471:Prostatic Neoplasms / Q000150:complications*; D012509:Sarcoma / Q000150:complications*; D014548:Urinary Fistula / Q000209:etiology* / Q000628:therapy*