Prolonged urinary leakage after partial nephrectomy: a novel management pathway.
BACKGROUND
To describe an original method for managing prolonged urinary leakage after partial nephrectomy. We placed a Malecot catheter in the ureter to improve the urinary drainage and therefore avoid the renal percutaneous treatment of the fistula or potential open surgery.


METHODS
We performed ureteral stenting using a 16 F Malecot catheter in 3 patients who had a prolonged urinary fistula after partial nephrectomy in which the placement of a ureteral stent could not resolve the urine leak. Drainage using 2 ureteral catheters was performed, which proved to be insufficient for the urinary fistula to resolve. We subsequently placed in the dilated ureter a 16 F Malecot catheter into the renal pelvis using a cystoscopic approach and a bladder catheter to complete the drainage. In all cases, the urine leak stopped after stenting with the Malecot catheter. At 1 month after the stenting, computed tomography and magnetic resonance imaging showed complete healing of the fistula. No infection or secondary ureteral stricture was reported.


CONCLUSIONS
This technique with a low complication profile can be used as an additional endoscopic step, before more invasive procedures.
Department of Urology, Groupe Hospitalier Paris Saint Joseph, Paris, France. Electronic address: fpgirard@hpsj.fr.
Frédéric
F
Girard
Department of Urology, Groupe Hospitalier Paris Saint Joseph, Paris, France.
Ruban
R
Thanigasalam
Department of Urology, Groupe Hospitalier Paris Saint Joseph, Paris, France.
Pierre Etienne
PE
Theveniaud
Department of Urology, Groupe Hospitalier Paris Saint Joseph, Paris, France.
Albert
A
El Hajj
Department of Urology, Groupe Hospitalier Paris Saint Joseph, Paris, France.
Christophe
C
Eimer
Department of Urology, Groupe Hospitalier Paris Saint Joseph, Paris, France.
Elodie
E
Sibileau
Department of Urology, Groupe Hospitalier Paris Saint Joseph, Paris, France.
Walid
W
Massoud
Department of Urology, Groupe Hospitalier Paris Saint Joseph, Paris, France.
Mohammed
M
Fennouri
Department of Urology, Groupe Hospitalier Paris Saint Joseph, Paris, France.
Hervé
H
Baumert
D002292:Carcinoma, Renal Cell / Q000601:surgery; D004867:Equipment Design; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D013997:Time Factors; D014546:Urinary Catheterization / Q000295:instrumentation*; D014548:Urinary Fistula / Q000209:etiology* / Q000628:therapy*