Ureteral Embolization to Prevent Thrombotic Obstruction of N
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Abstract :
We present a case of refractory hemorrhagic radiation cystitis in a patient who failed conservative management and was unable to undergo operative urinary diversion secondary to multiple comorbidities. His management was complicated by recurrent obstruction of his nephrostomy catheters due to marked ureteral thrombus formation from blood refluxing into the ureters from the urinary bladder. We were successful in treating his condition by occluding his distal ureters with a combination of embolization coils and glue to prevent the reflux of blood in order to allow his nephrostomy catheters to function properly.

Case Report :
A 78-year-old man with ischemic congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) presented to our institution with refractory hemorrhagic cystitis that developed after external beam radiation therapy (EBRT) for Gleason 3+4 prostate cancer. Prior to presentation at our hospital, he had undergone multiple cystoscopic clot evacuations, fulguration, and failed therapy with systemic and intravesical Amicar. During his hospitalization, he experienced significant hemorrhage requiring multiple blood transfusions and pressor support. Bilateral nephrostomy catheters were placed due to recurrent episodes of clot retention despite continuous bladder irrigation........

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4785251/
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