Open AccessPercutaneous Management of Persistent Urine Leak After Partial Nephrectomy: Sealing the Leak Site with Glue
Author(s) -
Ritesh Goel,
Brusabhanu Nayak,
Prabhjot Singh,
Shivanand Gamanagatti,
Richa Yadav
Publication year - 2020
Publication title -
journal of endourology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.123
H-Index - 1
ISSN - 2379-9889
DOI - 10.1089/cren.2020.0151
Subject(s) - medicine , nephrectomy , surgery , percutaneous , leak , fistula , stent , urinary fistula , urinary diversion , glue , percutaneous nephrolithotomy , percutaneous nephrostomy , complication , general surgery , cystectomy , cancer , kidney , bladder cancer , materials science , environmental engineering , engineering , composite material
Background: Localized urinary extravasation is a known complication after partial nephrectomy; however, rarely it forms a nephrocutaneous fistula. Nephrocutaneous fistula after partial nephrectomy is a management challenge for the treating surgeon. It is typically managed with indwelling ureteral stent placement. Persistent fistula after indwelling ureteral stent can be managed with percutaneous nephrostomy drainage. However, persistence after all these measures is a real therapeutic dilemma. Few reports are available on effective management of persistent urine leak by percutaneous obliteration of leak site using glue. Case Presentation: We report one such rare case of persistent nephrocutaneous fistula in a 41-year-old man of Indo-Aryan ethnicity. He was managed effectively with percutaneous cyanoacrylate glue application, when all the conservative methods failed. At 6 months follow-up he is doing well clinically and radiologically. Conclusion: Persistent nephrocutaneous fistula after partial nephrectomy is a rare and highly morbid condition, which leads to multiple intervention and prolonged hospital stay. Percutaneous glue application is a potential therapeutic approach to tackle such cases with good results.