Abstract
This retrospective study presents three consecutive patients who underwent bilateral ureteral occlusion using the Amplatzer vascular plugs and N-butyl cyanoacrylate glue sandwich method. The patients were 63- and 65-year-old males and a 79-year-old female. Indications for the procedure included severe cystitis and complex vesicular fistulas unresponsive to urinary diversion. All three patients had immediate resolution of urinary leakage, resulting in symptom relief throughout the follow-up period. There were no procedure-related complications or side effects.
Highlights
Radiation cystitis, vesicular fistulas, and bladder carcinoma are associated with significant reductions in patients’ quality of life and often result in pain, embarrassment from urinary leakage, and significant patient morbidity.[1]
Embolization, which is intended to be permanent, would only be considered in patients who are not candidates for surgical reconstruction and with symptoms refractory to long-term nephrostomy drainage alone or in combination with other treatments
Immediate technical and clinical success was achieved for all patients with no urinary leakage or migration of embolic agents (Fig. 3)
Summary
Vesicular fistulas, and bladder carcinoma are associated with significant reductions in patients’ quality of life and often result in pain, embarrassment from urinary leakage, and significant patient morbidity.[1]. Agents that have been utilized for ureteral embolization include liquid embolics, coils, balloons, and sponges.[1,2,3] More recently, combinations of embolization agents have been used, taking advantage of the strengths of individual agents to create a fast-setting but permanent occlusion. One novel technique utilizes an NBCA-Amplatzer ‘‘sandwich,’’ a combination of N-butyl cyanoacrylate (NBCA, TRUFILL; DePuy Synthes, West Chester, PA) injected between two Amplatzer vascular plugs (St. Jude Medical, St. Paul, MN) to create an immediate but long-lasting result.[1,4] this method was first described in 2013, there are still limited data on the effectiveness and potential consequences of this technique
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