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Therapeutic Ureteral Occlusion with Use of Occlusion Stents for Urinary Leakage or Fistula: A Bicentric Study

  • Clinical Investigation
  • Non-Vascular Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the safety and efficacy of ureteral occlusion stents for urinary diversion in patients with inoperable urinary leakage or fistula or intractable bladder bleeding.

Materials and Methods

A total of 13 ureters in 12 patients (M:F = 4:8) who underwent ureteral occlusion stenting were included in this study. The internally silicone membrane-coated occlusion stent was a self-expanding stent with constriction at the middle (M-type) or distal end (D-type) of the stent.

Results

The reasons for ureteral occlusion were surgery infeasibility for urinary leakage (n = 6), temporary ureteral occlusion for urinary leakage before surgical reconstruction (n = 2), urinary fistula (n = 3), or control of bleeding from bladder cancer (n = 1). Technical success defined as successful deployment of the occlusion stent with no contrast agent passing beyond the occlusion stent was achieved in 92.3% (12/13 ureters); in one ureter with contrast passage beyond the occlusion stent, additional n-butyl cyanoacrylate (NBCA) embolization was performed immediately so that there was no further leakage. There were no procedure-related complications. During the mean follow-up of 11.6 months, recurrence of urinary leakage was observed in two ureters (15.4%, 2/13) where a D-type occlusion stent was used on the 3-day follow-up antegrade ureterogram; the contrast agent passed through the widened constricted portion of the occlusion stent and repeat occlusion with microcoils, and NBCA was subsequently performed inside the occlusion stent and with no further urinary leakage until the last follow-up.

Conclusion

The ureteral occlusion stent is safe and effective for ureteral occlusion. Recurrence of leakage can be managed with additional microcoil and NBCA embolization.

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Funding

This study was not supported by any funding.

Author information

Author notes

  1. Chengshi Chen and Jong-Woo Kim contributed equally to this work and share the first authorship.

Authors and Affiliations

  1. Department of Radiology, The Affiliated Cancer Hospital of Zhengzhou University, No. 127 Dongming Road, Zhengzhou, 450008, China

    Chengshi Chen, Ji Hoon Shin & Hai-Liang Li

  2. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea

    Jong-Woo Kim, Ji Hoon Shin & Hee Ho Chu

  3. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Bumsik Hong

  4. Department of Radiology, Eulji Medical Center, Daejeon, Korea

    Chae-Hoon Kang

  5. Department of Radiology, GangNeung Asan Hospital, Gangneung, Gangwon Province, Korea

    Young-Jong Cho

Authors
  1. Chengshi Chen
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  2. Jong-Woo Kim
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  3. Ji Hoon Shin
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  7. Young-Jong Cho
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  8. Hee Ho Chu
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Corresponding author

Correspondence to Ji Hoon Shin.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the institutional review board at each participating hospital.

Informed Consent

For this type of study formal consent is not required. This study has obtained IRB approval from Asan Medical Center and Gangneung Asan Hospital and the need for informed consent was waived.

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Chen, C., Kim, JW., Shin, J.H. et al. Therapeutic Ureteral Occlusion with Use of Occlusion Stents for Urinary Leakage or Fistula: A Bicentric Study. Cardiovasc Intervent Radiol 43, 1492–1497 (2020). https://doi.org/10.1007/s00270-020-02610-6

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  • DOI: https://doi.org/10.1007/s00270-020-02610-6

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