title: Refractory urinary fistula with infundibular stenosis after partial nephrectomy.
abstract: A 71-year-old male patient who was diagnosed with renal cell carcinoma (cT1aN0M0) underwent a laparoscopic left partial nephrectomy. Because the bleeding could not be controlled, conversion to laparotomy was instigated. A ureteral stent was placed on confirmation of postoperative urine leakage from the drain, but the volume of drainage did not decrease. The findings of retrograde pyelography and computed tomography showed a urinary fistula resulting from isolated calyces caused by infundibular stenosis, for which transurethral dilatation for the stenosis was carried out. However, owing to the severity of stenosis, the guidewire was unable to achieve passage, and endoscopic dilatation was abandoned. Selective embolization of the left renal artery was then carried out. No drainage fluid was observed after embolization, and residual renal function of the left kidney was confirmed.
authors.affiliation: Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Junichi
authors.initials: J
authors.lastname: Ikeda
authors.forename: Motohiko
authors.initials: M
authors.lastname: Sugi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D003251:Constriction, Pathologic; D003558:Cystoscopy; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods; D014057:Tomography, X-Ray Computed; D014548:Urinary Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014567:Urography
keywords: embolization; infundibular stenosis; partial nephrectomy; renal cell carcinoma; urinary fistula