Management of incurable urinary fistulas by percutaneous ureteral occlusion

Abstract

Women with large urinary tract fistulas in the presence of advanced incurable gynecologic cancer are a difficult problem. In the past, treatment has usually been either inadequate or highly morbid. We have palliated three women with large incurable urinary tract fistulas by occluding the distal ureters with isobutyl-2-cyanoacrylate (Bucrylate) and implanting permanent bilateral percutaneous nephrostomies. This technique is easily performed and effective, and has few complications.