Refractory urinary fistula with infundibular stenosis after partial nephrectomy

• Published in: International journal of urology Vol. 22; no. 2; pp. 219 - 221
• Main Authors: Yamamoto, Teppei, Kinoshita, Hidefumi, Ikeda, Junichi, Sugi, Motohiko, Matsuda, Tadashi
• Format: Journal Article
• Language: English
• Published: Australia 01.02.2015
• Subjects: Aged; Carcinoma, Renal Cell - surgery; Constriction, Pathologic; Cystoscopy; embolization; Follow-Up Studies; Humans; infundibular stenosis; Kidney Neoplasms - surgery; Male; Nephrectomy - adverse effects; partial nephrectomy; Postoperative Complications; Reconstructive Surgical Procedures - methods; renal cell carcinoma; Tomography, X-Ray Computed; urinary fistula; Urinary Fistula - diagnosis; Urinary Fistula - etiology; Urinary Fistula - surgery; Urography; renal cell carcinoma; infundibular stenosis; embolization; partial nephrectomy; urinary fistula
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/iju.12629

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.