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Interventional Radiology for Drainage of Urine

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Imaging and Intervention in Urinary Tract Infections and Urosepsis

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Abstract

Several techniques and devices are available for urinary drainage. The choice depends on patient’s clinical problem, relevant laboratory data, availability of materials, and preferences and experience of the operator.

Indications for drainage and the goals of care must be clear before starting to achieve safely the desired outcome.

The patient should be sufficiently knowledgeable to participate in decision-making about his care.

Urinary drainage procedures are used to treat a wide range of clinical situations including pyonephrosis and preservation of renal function in patients with obstructive urologic pathologies, as a means to access the collecting system for stone retrieval or lithotripsy and to divert urine from a distal leak or fistula.

In this field, interventional radiology techniques are proposed as a less invasive alternative to the surgical approach, which is often difficult and aggravated by high failure and complication rates.

Moreover, low morbidity and mortality rates are associated with these procedures.

The following represents one scenario of approaches to patients who require urinary drainage, with a focus on choosing and placing the most appropriate device in a variety of clinical situations.

A description of indications, techniques, complications, and management of these patients is reported both in the native and transplanted kidneys.

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References

  1. Hsu L, Li H, Pucheril D et al (2016) Use of percutaneous nephrostomy and ureteral stenting in management of ureteral obstruction. World J Nephrol 5(2):172–181

    Article  PubMed  PubMed Central  Google Scholar 

  2. Heyns CF (2012) Urinary tract infection associated with conditions causing urinary tract obstruction and stasis, excluding urolithiasis and neuropathic bladder. World J Urol 30(1):77–83

    Article  CAS  PubMed  Google Scholar 

  3. Thornton RH, Covey AM (2016) Urinary drainage procedures in interventional radiology. Tech Vasc Interv Radiol 19(3):170–181

    Article  PubMed  Google Scholar 

  4. Venkatesan AM, Kundu S, Sacks D et al (2010) Practice guidelines for adult antibiotic prophylaxis during vascular and interventional radiology procedures. Written by the Standards of Practice Committee for the Society of Interventional Radiology and Endorsed by the Cardiovascular Interventional Radiological Society of Europe and Canadian Interventional Radiology Association [corrected]. J Vasc Interv Radiol 21(11):1611–1630

    Article  PubMed  Google Scholar 

  5. Bultitude M, Rees J (2012) Management of renal colic. BMJ 345:e5499

    Article  PubMed  Google Scholar 

  6. Mokhmalji H, Braun PM, Martinez Portillo FJ, Siegsmund M, Alken P, Köhrmann KU (2001) Percutaneous nephrostomy versus ureteral stents for diversion of hydronephrosis caused by stones: a prospective, randomized clinical trial. J Urol 165(4):1088–1092

    Article  CAS  PubMed  Google Scholar 

  7. Dagli M, Ramchandani P (2011) Percutaneous nephrostomy: technical aspects and indications. Semin Intervent Radiol 28(4):424–437

    Article  PubMed  PubMed Central  Google Scholar 

  8. Chitale SV, Scott-barrett S, Ho ET, Burgess NA (2002) The management of ureteric obstruction secondary to malignant pelvic disease. Clin Radiol 57(12):1118–1121

    Article  CAS  PubMed  Google Scholar 

  9. Malloy PC, Grassi CJ, Kundu S et al (2009) Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 20(7 Suppl):S240–S249

    Article  PubMed  Google Scholar 

  10. Pabon-ramos WM, Dariushnia SR, Walker TG et al (2016) Quality improvement guidelines for percutaneous nephrostomy. J Vasc Interv Radiol 27(3):410–414

    Article  PubMed  Google Scholar 

  11. Springer RM (2015) Planning and execution of access for percutaneous renal stone removal in a community hospital setting. Semin Intervent Radiol. 32(3):311–322

    Article  PubMed  PubMed Central  Google Scholar 

  12. Miller NL, Matlaga BR, Lingeman JE (2007) Techniques for fluoroscopic percutaneous renal access. J Urol 178(1):15–23

    Article  PubMed  Google Scholar 

  13. Osman M, Wendt-nordahl G, Heger K, Michel MS, Alken P, Knoll T (2005) Percutaneous nephrolithotomy with ultrasonography-guided renal access: experience from over 300 cases. BJU Int 96(6):875–878

    Article  PubMed  Google Scholar 

  14. Ristau BT, Averch TD, Tomaszewski JJ (2011) Percutaneous renal access by urologist or radiologist: a review of the literature. Nephro-Urol Mon 3(4):252–257

    Google Scholar 

  15. Carrafiello G, Laganà D, Mangini M et al (2006) Complications of percutaneous nephrostomy in the treatment of malignant ureteral obstructions: single-centre review. Radiol Med 111(4):562–571

    Article  CAS  PubMed  Google Scholar 

  16. Ray CE, Brown AC, Smith MT, Rochon PJ (2014) Percutaneous access of nondilated renal collecting systems. Semin Intervent Radiol. 31(1):98–100

    Article  PubMed  PubMed Central  Google Scholar 

  17. Patel U, Abubacker MZ (2004) Ureteral stent placement without postprocedural nephrostomy tube: experience in 41 patients. Radiology 230(2):435–442

    Article  PubMed  Google Scholar 

  18. Sommer CM, Huber J, Radeleff BA et al (2011) Combined CT- and fluoroscopy-guided nephrostomy in patients with non-obstructive uropathy due to urine leaks in cases of failed ultrasound-guided procedures. Eur J Radiol 80(3):686–691

    Article  CAS  PubMed  Google Scholar 

  19. Chien GW, Bellman GC (2002) Blind percutaneous renal access. J Endourol 16(2):93–96

    Article  PubMed  Google Scholar 

  20. Lee MJ, Papanicolaou N, Nocks BN, Valdez JA, Yoder IC (1993) Fluoroscopically guided percutaneous suprapubic cystostomy for long-term bladder drainage: an alternative to surgical cystostomy. Radiology 188(3):787–789

    Article  CAS  PubMed  Google Scholar 

  21. Pilcher JM, Patel U (2002) Choosing the correct length of ureteric stent: a formula based on the patient’s height compared with direct ureteric measurement. Clin Radiol 57(1):59–62

    Article  CAS  PubMed  Google Scholar 

  22. Fiuk J, Bao Y, Calleary JG, Schwartz BF, Denstedt JD (2015) The use of internal stents in chronic ureteral obstruction. J Urol 193(4):1092–1100

    Article  PubMed  Google Scholar 

  23. Cauda F, Cauda V, Fiori C, Onida B, Garrone E (2008) Heparin coating on ureteral double J stents prevents encrustations: an in vivo case study. J Endourol 22(3):465–472

    Article  PubMed  Google Scholar 

  24. Chung HH, Lee SH, Cho SB et al (2008) Comparison of a new polytetrafluoroethylene-covered metallic stent to a noncovered stent in canine ureters. Cardiovasc Intervent Radiol 31(3):619–628

    Article  PubMed  Google Scholar 

  25. Krambeck AE, Walsh RS, Denstedt JD et al (2010) A novel drug eluting ureteral stent: a prospective, randomized, multicenter clinical trial to evaluate the safety and effectiveness of a ketorolac loaded ureteral stent. J Urol 183(3):1037–1042

    Article  PubMed  Google Scholar 

  26. Lang EK, Winer AG, Abbey-mensah G et al (2013) Long-term results of metallic stents for malignant ureteral obstruction in advanced cervical carcinoma. J Endourol 27(5):646–651

    Article  PubMed  Google Scholar 

  27. Wang HJ, Lee TY, Luo HL et al (2011) Application of resonance metallic stents for ureteral obstruction. BJU Int 108(3):428–432

    Article  PubMed  Google Scholar 

  28. Hekimoğlu B, Men S, Pinar A et al (1996) Urothelial hyperplasia complicating use of metal stents in malignant ureteral obstruction. Eur Radiol 6(5):675–681

    PubMed  Google Scholar 

  29. Atar E, Bachar GN, Bartal G et al (2005) Use of peripheral cutting balloon in the management of resistant benign ureteral and biliary strictures. J Vasc Interv Radiol 16(2 Pt 1):241–245

    Article  PubMed  Google Scholar 

  30. Fonio P, Appendino E, Calandri M, Faletti R, Righi D, Gandini G (2015) Treatment of urological complications in more than 1,000 kidney transplantations: the role of interventional radiology. Radiol Med 120(2):206–212

    Article  PubMed  Google Scholar 

  31. Kumar S, Jeon JH, Hakim A, Shrivastava S, Banerjee D, Patel U (2016) Long-term graft and patient survival after balloon dilation of ureteric stenosis after renal transplant: a 23-year retrospective matched cohort study. Radiology 281(1):301–310

    Article  PubMed  Google Scholar 

  32. Atar E, Bachar GN, Eitan M, Graif F, Neyman H, Belenky A (2007) Peripheral cutting balloon in the management of resistant benign ureteral and biliary strictures: long-term results. Diagn Interv Radiol 13(1):39–41

    PubMed  Google Scholar 

  33. Carrafiello G, Laganà D, Mangini M et al (2007) Fluoroscopically guided retrograde replacement of ureteral stents. Radiol Med 112(6):821–825

    Article  CAS  PubMed  Google Scholar 

  34. Vanderbrink BA, Rastinehad AR, Ost MC, Smith AD (2008) Encrusted urinary stents: evaluation and endourologic management. J Endourol 22(5):905–912

    Article  PubMed  Google Scholar 

  35. De baere T, Denys A, Pappas P, Challier E, Roche A (1994) Ureteral stents: exchange under fluoroscopic control as an effective alternative to cystoscopy. Radiology 190(3):887–889

    Article  PubMed  Google Scholar 

  36. Lang EK, Allaei A, Robinson L, Reid J, Zinn H (2015) Minimally invasive radiologic techniques in the treatment of uretero-enteric fistulas. Diagn Interv Imaging 96(11):1153–1160

    Article  CAS  PubMed  Google Scholar 

  37. Katske FA, Celis P (1991) Technique for removal of migrated double-J ureteral stent. Urology 37(6):579

    Article  CAS  PubMed  Google Scholar 

  38. Liang HL, Yang TL, Huang JS et al (2008) Antegrade retrieval of ureteral stents through an 8-French percutaneous nephrostomy route. AJR Am J Roentgenol 191(5):1530–1535

    Article  PubMed  Google Scholar 

  39. Ganatra AM, Loughlin KR (2005) The management of malignant ureteral obstruction treated with ureteral stents. J Urol 174(6):2125–2128

    Google Scholar 

  40. Alago W, Sofocleous CT, Covey AM et al (2008) Placement of transileal conduit retrograde nephroureteral stents in patients with ureteral obstruction after cystectomy: technique and outcome. AJR Am J Roentgenol 191(5):1536–1539

    Google Scholar 

  41. Tal R, Bachar GN, Baniel J, Belenky A (2004) External-internal nephro-uretero-ileal stents in patients with an ileal conduit: long-term results. Urology 63(3):438–441

    Google Scholar 

  42. Ingraham CR, Montenovo M (2016) Interventional and surgical techniques in solid organ transplantation. Radiol Clin N Am 54(2):267–280

    Google Scholar 

  43. Nikolic B, Rose SC, Ortiz J et al (2012) Standards of reporting for interventional radiology treatment of renal and pancreatic transplantation complications. J Vasc Interv Radiol 23(12):1547–1556

    Google Scholar 

  44. Kobayashi K, Censullo ML, Rossman LL, Kyriakides PN, Kahan BD, Cohen AM (2007) Interventional radiologic management of renal transplant dysfunction: indications, limitations, and technical considerations. Radiographics 27(4):1109–1130

    Google Scholar 

  45. Kolli KP, Laberge JM (2016) Interventional management of nonvascular renal transplant complications. Tech Vasc Interv Radiol 19(3):218–227

    Google Scholar 

  46. Dyer RB, Chen MY, Zagoria RJ, Regan JD, Hood CG, Kavanagh PV (2002) Complications of ureteral stent placement. Radiographics 22(5):1005–1022

    Google Scholar 

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Author information

Authors and Affiliations

  1. Diagnostic and Interventional Radiology Department, ASST Santi Paolo e Carlo, Via A di Rudinì 8, Milan, 20142, Italy

    Anna Maria Ierardi, Salvatore Alessio Angileri, Enrico Maria Fumarola & Gianpaolo Carrafiello

Authors
  1. Anna Maria Ierardi
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  2. Salvatore Alessio Angileri
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  3. Enrico Maria Fumarola
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  4. Gianpaolo Carrafiello
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Corresponding author

Correspondence to Anna Maria Ierardi .

Editor information

Editors and Affiliations

  1. Department of Radiology, Luigi Sacco Hospital, Milan, Italy

    Massimo Tonolini

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Ierardi, A.M., Angileri, S.A., Fumarola, E.M., Carrafiello, G. (2018). Interventional Radiology for Drainage of Urine. In: Tonolini, M. (eds) Imaging and Intervention in Urinary Tract Infections and Urosepsis. Springer, Cham. https://doi.org/10.1007/978-3-319-68276-1_20

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  • DOI: https://doi.org/10.1007/978-3-319-68276-1_20

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-68275-4

  • Online ISBN: 978-3-319-68276-1

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