Successful renal transcatheter arterial embolization in three patients with symptomatic hydronephrosis due to ureteral obstruction

Intern Med. 2006;45(12):769-74. doi: 10.2169/internalmedicine.45.1659. Epub 2006 Jul 18.

Abstract

Background: Conventional treatments for symptomatic enlargement of a nonfunctional hydronephrotic kidney caused by obstructive uropathy include surgical treatments.

Methods: Patients included a 67-year-old woman whose obstruction was caused by a lower urinary tract stone complicating spinal tuberculosis (patient 1); a 52-year-old man with compressive complete congenital obstruction crossing the ureteropelvic junction from an aberrant renal artery (patient 2); and a 19-year-old woman with essentially complete idiopathic congenital obstruction at the ureteropelvic junction (patient 3), who required antibiotics for pyelonephritis before embolization. The renal artery was embolized using platinum microcoils.

Results: Although the sensation of abdominal fullness diminished within approximately two week after TAE, it took one to two years until the embolized kidney size shrank from 1377+/-634 cm3 (range, 829 to 2072) to 43+/-46 cm3 (42 to 94) by the evaluation of computed tomography. Fever after embolization persisted for 5 days in patient 1, 3 in patient 2, and 9 in patient 3. Flank pain resolved within 5 days in all. Pyelonephritis and complications of treatment have not occurred.

Conclusion: Embolization for this indication was safe and effective.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Female
  • Flank Pain / etiology
  • Humans
  • Hydronephrosis / diagnostic imaging
  • Hydronephrosis / etiology
  • Hydronephrosis / therapy*
  • Male
  • Middle Aged
  • Pyelonephritis / etiology
  • Pyelonephritis / therapy*
  • Radiography
  • Renal Artery* / diagnostic imaging
  • Ureteral Obstruction / complications
  • Ureteral Obstruction / diagnostic imaging
  • Ureteral Obstruction / therapy*