Educational Exhibit Abstract No. 243 - IR management of ureteral leaks

Abstract

Learning Objectives To educate and inform the reader about the management of ureteral leaks utilizing temporary and permanent treatment options. Background Ureteral leaks can develop in the setting of iatrogenic, inflammatory, neoplastic, and post-traumatic conditions. Urinary diversion is a well-established technique that gives the body time to heal and seal the leak in the ureter. Traditional methods range from percutaneous nephrostomy tubes to double-J ureteral stents. However, there are instances in which temporary or permanent occlusion is required for complete urinary diversion when traditional methods are unsuccessful. These treatment options are less invasive options than those offered by surgeons or urologists. A thorough understanding of the treatment options will help the interventional radiologist provide the best and least invasive care for the patient with a ureteral leak. Clinical Findings/Procedure Details Multiple cases demonstrating ureteral leaks that were managed with a variety of methods ranging from percutaneous nephrostomy to permanent ureteral occlusion to allow for urinary diversion. Imaging findings and key procedural tips are discussed where applicable. Indications for further imaging or additional work-up are addressed. Conclusion and/or Teaching Points Urinary diversion is an effective method of treating ureteral leaks to allow for either healing of the injured segment or for complete urinary diversion when distal drainage is not desired. Various methods are described and can be utilized in the hands of a skilled interventional radiologist.