Transrenal ureteral occlusion: results and problems.

PURPOSE

The effectiveness of transrenal ureteral occlusion was evaluated.

PATIENTS AND METHODS

Transrenal ureteral occlusions were performed in 83 ureters of 76 patients. Thirty-one ureters were occluded with use of tissue adhesive, which was secured in place with Gianturco coils in 21. Fifty-two ureters were occluded by means of silicone-filled, detachable latex balloons. Average follow-up was 3.6 months (range, 1 week to 38 months) for patients treated with the tissue adhesive and 7.9 months (range, 1 week to 61 months) for patients treated with the detachable balloons.

RESULTS

Seventeen (55%) of the 31 ureters occluded with tissue adhesive and 36 (69%) of the 52 ureters occluded with detachable balloons were permanently sealed after a single procedure. In 30 ureters, the occlusion procedure had to be repeated. The average duration of temporarily effective occlusions was 2.5 weeks when tissue adhesive was used and 19.5 weeks with detachable balloons. Complications were observed in 10 (7%) of 138 interventions. Only four of these were considered significant: two perforations occurred at the ureteropelvic junction, septicemia was seen after one procedure, and damage to a small intrarenal artery necessitated selective embolization in one patient.

CONCLUSIONS

In selected patients, transrenal ureteral occlusion can effectively and safely interrupt urinary flow toward the bladder. Detachable balloons were superior to tissue adhesive as an occluding agent.