ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2021
vol. 86
 
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Interventional radiology
abstract:
Case report

Percutaneous embolization of contained iatrogenic vesicourethral fistula using AVP and NBCA: a case report

Ibrahim Alrashidi
1, 2
,
Rehab Alharbi
3
,
Ji Hoon Shin
2

1.
Prince Sultan Military Medical City, Riyadh, Saudi Arabia
2.
Asan Medical Center, Seoul, South Korea
3.
Faculty of Medicine, Hail University, Saudi Arabia
© Pol J Radiol 2021; 86: e500-e503
Online publish date: 2021/08/24
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Purpose: Reports on percutaneous embolization of vesicourethral anastomotic fistula are limited.

Case presentation: A 59-year-old male presented with persistent contained vesicourethral fistula following low anterior resection and radical retropubic prostectomy for rectal cancer. A contained fistula with urinary leakage of 350 ml/day through a Jackson-Pratt (JP) tube was found at the posterior aspect of the vesicourethral anastomotic site on cystography. After 1 month of failed conventional urinary drainage manoeuvre, percutaneous embolization of the contained fistula was successfully performed through the JP tube. An Amplatzer vascular plug (AVP) was used to block the fistula and N-butyl-2-cyanoacrylate (NBCA) was used to obliterate the urinoma cavity. Computed tomography scans at 1-month and 1-year follow-ups showed stable AVP position and complete obliteration of the cavity by NBCA.

Conclusions: The contained vesicourethral anastomotic fistula was successfully managed with AVP and NBCA via a JP drainage tube. It is expected that AVP will block the fistula and NBCA will obliterate the urinoma cavity effectively.
keywords:

urinary fistula, urinary bladder, therapeutic embolization




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