Transrenal ureteral occlusion with the use of microcoils in five patients with ureterovaginal fistulas

Background: To evaluate the feasibility and efficacy of transrenal ureteral occlusion with microcoils in patients with ureterovaginal fistulas. Methods: Five women (median age 44 years, range 26-51 years) with ureterovaginal fistulas were treated by transrenal ureteral occlusion with microcoils. The underlying diseases were uterine fibroids (n = 3), a primitive neuroectodermal tumor of the uterine cervix (n = 1), and an ovarian cancer (n = 1). Microcoils with or without gelatin sponges, were placed antegradely through a percutaneous nephrostomy (PCN). A PCN tube was then placed to provide an external diversion. Results: The transrenal ureteral occlusion was technically successfully in all patients. Complete or near complete (<1 pad/day) dryness was obtained in all patients within 3 days. No complications other than a slight proximal migration of the microcoils in two patients occurred. The PCN tubes were removed in four of the five patients during the follow-up period with the subsequent procedures: antegrade ureteral stent placement, patent normal ureter, an ureteroneocystostomy and a laparoscopic end-to-end anastomosis of the ureter. Conclusions: Transrenal ureteral occlusion with microcoils with or without gelatin sponges is a safe and reliable method for the management of patients with ureterovaginal fistulas