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Exchange of Retrograde Occluded Nephroureteral Catheter Through Ileal Conduits Without Losing Access 

Exchange of Retrograde Occluded Nephroureteral Catheter Through Ileal Conduits Without Losing Access
Chapter:
Exchange of Retrograde Occluded Nephroureteral Catheter Through Ileal Conduits Without Losing Access
Author(s):

Jayesh M. Soni

DOI:
10.1093/med/9780199986071.003.0091
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date: 27 February 2020

A retrograde nephroureteral catheter is placed in patients who have undergone cystectomy with ileal conduit formation. An ileal conduit connects the ureters to a loop of bowel that is then secured to the anterior abdominal wall to allow for ostomy bag drainage. Patients may develop complications in the form of stricture at the ureteroenteric junction causing obstruction. These patients may need temporary diversion of urine through a nephrostomy catheter. The retrograde nephroureteral catheter is a better option because it provides a less invasive and safer approach. Unlike the routine exchange of a nephroureteral catheter over the wire through the ileal conduit, wire access through the catheter to the renal pelvis is sometimes difficult or impossible due to encrustation with calcium deposition, catheter fracture, and catheter migration. Alternative techniques to avoid these complications include the use of a parallel glidewire or use of a larger sheath over the catheter or the catheter snare.

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