Skip to main content

Advertisement

SpringerLink
Log in

Management of urinary-tract fistulas using reversible balloon nephrostomy: a single-center retrospective analysis of 56 patients

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the effectiveness of balloon nephrostomy (BN) for treating urinary tract fistulas.

Materials and methods

In a single-center retrospective analysis, 56 patients were treated using BN between 2003 and 2014. All causes of urinary tract fistula were included. We assessed the effectiveness of drainage, complications, and the types of reconstruction surgery used. Success was defined as fistula closure without surgery.

Results

The cohort consisted of 25 males (54%) and 31 females (55%) with a median age of 63 years who underwent BN for a urinary fistula secondary to surgery, i.e., urologic (40%; n = 22), gynecologic (34%; n = 19), or digestive (20%; n = 11). Of these patients, 48 (86%) had a history of cancer (49% had a tumor progression). Median drainage time was 90 days (10–583), with an average of three successive readjustments needed per patient. We obtained a 21% success rate (n = 12), morbidity was 6.5% (urinary sepsis, renal abscess, ureteral stricture), and 7% of patients developed ureteral stricture after balloon removal. There was no recurrence of any fistula within a median follow-up time of 15.2 months.

Conclusion

This minimally invasive procedure can be used for selected urinary tract fistulas with few complications. It can also be used safely in populations that have several comorbidities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Lynch TH, Martinez-Pineiro L, Plas E, Serafetinides E, Turkeri L, Santucci RA, et al. EAU guidelines on urological trauma. Eur Urol. 2005;47(1):1–15.

    Article  PubMed  Google Scholar 

  2. Flores-Carreras O, Cabrera JR, Galeano PA, Torres FE. Fistulas of the urinary tract in gynecologic and obstetric surgery. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(3):203–14.

    Article  CAS  PubMed  Google Scholar 

  3. Hennessey DB, Bolton E, Thomas AZ, Lynch TH (2013) Vesicocutaneous fistula following adjuvant radiotherapy for prostate cancer. BMJ Case reports. https://doi.org/10.1136/bcr-2013-008986

  4. Bryk DJ, Zhao LC (2015) Guideline of guidelines: A review of urologic trauma guidelines. BJU Int.

  5. Aristide Kabore F, Kambou T, Ouattara A, Zango B, Yameogo C, Kirakoya B, et al. Epidemiology, etiology and psychosocial impact of urogenital fistulas in a cohort of 170 consecutive patients managed in three treatment centers in Burkina Faso from 2010 to 2012. Prog Urol. 2014;24(8):526–32.

    Article  CAS  PubMed  Google Scholar 

  6. Obarisiagbon EO, Olagbuji BN, Onuora VC, Oguike TC, Ande AB. Iatrogenic urological injuries complicating obstetric and gynaecological procedures. Singap Med J. 2011;52(10):738–41.

    CAS  Google Scholar 

  7. Koukouras D, Petsas T, Liatsikos E, Kallidonis P, Sdralis EK, Adonakis G, et al. Percutaneous minimally invasive management of iatrogenic ureteral injuries. J Endourol/Endourol Soc. 2010;24(12):1921–7.

    Article  Google Scholar 

  8. Msezane L, Reynolds WS, Mhapsekar R, Gerber G, Steinberg G. Open surgical repair of ureteral strictures and fistulas following radical cystectomy and urinary diversion. J Urol. 2008;179(4):1428–31.

    Article  PubMed  Google Scholar 

  9. Avritscher R, Madoff DC, Ramirez PT, Wallace MJ, Ahrar K, Morello FA Jr, et al. Fistulas of the lower urinary tract: percutaneous approaches for the management of a difficult clinical entity. Radiographics. 2004;24(Suppl 1):S217–36.

    Article  PubMed  Google Scholar 

  10. Gunther RW, Klose KJ, Alken P, Bohl J. Transrenal ureteral occlusion using a detachable balloon. Urol Radiol. 1984;6(3-4):210–4.

    Article  CAS  PubMed  Google Scholar 

  11. Horenblas S, Kroger R, van Boven E, Meinhardt W, Newling DW. Use of balloon catheters for ureteral occlusion in urinary leakage. Eur Urol. 2000;38(5):613–7.

    Article  CAS  PubMed  Google Scholar 

  12. Zairi A, Nohra J, Khedis M, Thoulouzan M, Otal P, Joffre F, et al. Results of balloon nephrostomy in the treatment of lower urinary tract fistula. Prog Urol: J Assoc Fr Urol Soc Fr Urol. 2008;18(6):372–8.

    Article  CAS  Google Scholar 

  13. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.

    Article  PubMed  PubMed Central  Google Scholar 

  14. De Ridder D. An update on surgery for vesicovaginal and urethrovaginal fistulae. Curr Opin Urol. 2011;21(4):297–300.

    Article  PubMed  Google Scholar 

  15. Burks FN, Santucci RA. Management of iatrogenic ureteral injury. Ther Adv Urol. 2014;6(3):115–24.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Al-Otaibi KM. Ureterovaginal fistulas: the role of endoscopy and a percutaneous approach. Urol Ann. 2012;4(2):102–5.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Franke M, Winand S, Chang DH, Wille S, Maintz D, Bangard C. Urinary tract fistulas: Transrenal reversible ureteral occlusion with detachable Semicompliant balloons. Urology. 2015;86(2):388–93.

    Article  PubMed  Google Scholar 

  18. Oakley SH, Brown HW, Greer JA, Richardson ML, Adelowo A, Yurteri-Kaplan L, et al. Management of vesicovaginal fistulae: a multicenter analysis from the Fellows’ pelvic research network. Female Pelvic Med Reconstr Surg. 2014;20(1):7–13.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Papanicolaou N, Pfister RC, Yoder IC. Percutaneous occlusion of ureteral leaks and fistulae using nondetachable balloons. Urol Radiol. 1985;7(1):28–31.

    Article  CAS  PubMed  Google Scholar 

  20. Li C, Liu Z, Yang F. Predictors of catheter-related bladder discomfort after urological surgery. J Huazhong Univ Sci Technol Med Sci. 2014;34(4):559–62.

    Article  CAS  PubMed  Google Scholar 

  21. Waaldijk K. The immediate surgical management of fresh obstetric fistulas with catheter and/or early closure. Int J Gynaecol Obstet. 1994;45(1):11–6.

    Article  CAS  PubMed  Google Scholar 

  22. Linder BJ, Umbreit EC, Larson D, Dozois EJ, Thapa P, Elliott DS. Effect of prior radiotherapy and ablative therapy on surgical outcomes for the treatment of rectourethral fistulas. J Urol. 2013;190(4):1287–91.

    Article  PubMed  Google Scholar 

  23. Degirmenci T, Gunlusoy B, Kozacioglu Z, Arslan M, Ceylan Y, Ors B, et al. Utilization of a modified Clavien classification system in reporting complications after ultrasound-guided percutaneous nephrostomy tube placement: comparison to standard Society of Interventional Radiology practice guidelines. Urology. 2013;81(6):1161–7.

    Article  PubMed  Google Scholar 

  24. Paluku JL, Carter TE. Obstetric vesico-vaginal fistulae seen in the northern Democratic Republic of Congo: a descriptive study. Afr Health Sci. 2015;15(4):1104–11.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Andrology and Kidney Transplantation, CHU Toulouse, Toulouse, 31059, France

    Jérôme Gas, François-Xavier Nouhaud, Mathieu Roumiguié, Éric Huyghe, Michel Soulié, Xavier Gamé & Jean-Baptiste Beauval

  2. Department of Radiology, CHU Toulouse, Toulouse, 31059, France

    Séverine Lagarde & Marie-Charlotte Delchier

Authors
  1. Jérôme Gas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. François-Xavier Nouhaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mathieu Roumiguié
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Séverine Lagarde
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marie-Charlotte Delchier
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Éric Huyghe
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michel Soulié
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Xavier Gamé
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jean-Baptiste Beauval
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jérôme Gas.

Ethics declarations

Conflicts of interest

None.

Ethical standards

The patients’ characteristics and treatment strategies were collected by screening medical records after approval from our Institutional Review Board.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gas, J., Nouhaud, FX., Roumiguié, M. et al. Management of urinary-tract fistulas using reversible balloon nephrostomy: a single-center retrospective analysis of 56 patients. Int Urogynecol J 30, 287–292 (2019). https://doi.org/10.1007/s00192-018-3628-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-018-3628-0

Keywords

Search

Navigation