Ureterocutaneous fistula: a case report of treatment by subtrigonal injection of polytetrafluoroethylene (Sting procedure)

Endoscopic management of a chronic ureterocutaneous fistula using cyanoacrylic glue

Ureterocutaneous fistula is a rare complication of renal surgery. Cyanoacrylate glue is a tissue adhesive, used primarily for the endoscopic control of bleeding from gastric varices. A female aged 33 presented to our facility with a ureterocutaneous fistula after surgery. We used a retrograde endoscopic approach for the instillation of 2 ml of sealant into the ureteral lumen to seal the ureter and fistulous tract. The fistulous opening healed spontaneously a week after the procedure, and the patient remained dry and symptom free for 5 months following the procedure. Endoscopic delivery of cyanoacrylate sealant was a feasible and effective way in treating a ureterocutaneous fistula in our patient.

Successful endoscopic management of a chronic transplant ureterocutaneous fistula

OBJECTIVE

To illustrate a minimally invasive, well-tolerated, clinically, and cost-effective method for surgically managing a high-output, transplant ureterocutaneous fistula manifesting as chronic urinary tract infection and recurrent pyelonephritis. This method will subject the immunosuppressed patient to less morbidity and minimize risk to the functioning renal graft.

METHODS

A combined percutaneous-endoscopic fistula closure method was developed using Deflux® to cystoscopically occlude the transplant ureteral orifice and Bioglue® to seal the ureter and fistula tract.

RESULTS

The patient was infection free, completely dry, and had no voiding dysfunction after undergoing this occlusion method.

CONCLUSION

This report demonstrates that this minimally invasive technique is a safe, well-tolerated, and effective technique that may be offered as an outpatient, first-line therapy over open or laparoscopic excision.

[Ureterocutaneous fistula after nephrectomy: two cases]

The ureteral fistulas are related to the gynecological surgery, digestive surgery and reconstructive urologic surgery of the upper urinary tract. Fistulas are described ureterovaginal, ureteroduodenal, ureterocolonic, ureteropleural, ureterovascular, etc. However, the ureterocutaneous fistulas of the ureteral stump after nephrectomy are a very unusual entity. We report two cases as well as their resolution by means of surgery.