Retrograde Urinary Drainage: A Combined Approach

Abstract

Retrograde transvesical drainage of the kidney is a safe and proven technique. However, in the presence of high-grade ureteral obstruction, it is sometimes difficult to afford adequate drainage. In 22 of 24 successive cases, successful drainage was provided once access to the distal ureter was achieved cystoscopically. In two patients, it was necessary to proceed to percutaneous nephrostomy tube placement. Retrograde transvesical drainage was extended to include drainage of ureters anastomosed to neobladders and ileal conduits, with success in eight of eight patients. The techniques necessary to achieve this high success rate are described.