Novel Bilateral Ureteral Occlusion with Modified Expandable Metal Stents to Achieve Complete but Reversible Urinary Diversion.

Urologists face a significant challenge when presented with cases in which complete, yet reversible, urinary diversion is desirable. With multidisciplinary collaboration, we have used a novel technique involving the antegrade deployment of distally-ligated covered metal (Allium®) ureteral stents, achieving ureteral occlusion and complete urinary diversion via nephrostomy tubes. We have used this technique, with good early results, in complex cases, including that of a young male patient with complex pelvic injuries after polytrauma and a female patient with a malignant vesicovaginal fistula, neither of whom were candidates for definitive surgical reconstruction or diversion at the time of treatment. We describe our experience, which we believe may be of interest to urologists and interventional radiologists managing similarly challenging cases.