Endoureteral ablation: A novel technique to occlude the ureter in patients with urinary tract fistulae

Abstract

Urinary fistulae are abnormal connections between the urinary system and adjacent body parts, often resulting from factors such as infection, radiation, malignancy, protracted labor, gynecologic surgery, and gastrointestinal tract surgery. These fistulae can lead to persistent urinary incontinence, skin breakdown, social humiliation, psychosocial trauma, and severe infections. Current treatments include surgical repair, urinary diversion, and ureteral embolization, though these can have complications and are not always successful or feasible for all patients. This manuscript proposes a novel approach to correcting urinary fistulae: Endoureteral ablation using laser or radiofrequency ablation. These techniques, known for treating various conditions, show promise in causing fibrosis to occlude fistulae. Early success in animal and human models suggests endoureteral ablation as a potentially more effective, less invasive, and cost-effective alternative to current methods, especially for patients unfit for surgery. However, further studies are needed to establish its viability and effectiveness.

Keywords: Endoureteral ablation; Laser ablation; Radiofrequency ablation; Ureteral embolization; Urinary fistula.