Nonvascular intervention in the genitourinary tract.

The past few years have seen significant expansion in interventional genitourinary radiology. Balloon dilatation of the prostate is a new, safe procedure that may be offered as a surgical alternative to high-risk patients as well as to younger patients wishing to avoid surgical complications. The procedure is contraindicated in patients with middle lobe hypertrophy, carcinoma, very large glands, or a history of retention. Because of the lack of large randomized controlled studies, the procedure should still be considered investigational. Transcervical fallopian tube recanalization for proximal tubal occlusion is another new outpatient procedure with low morbidity and cost compared with the more expensive alternatives of in vitro fertilization and tubal microsurgery. Pregnancy rates approach 60% in selected subgroups of patients. Furthermore, selective salpingography may provide diagnostic information not available with conventional hysterosalpingography. The most recent advance in renal parenchymal biopsy has been the development of an automated biopsy gun, which, in conjunction with real-time ultrasonographic monitoring, has increased the ease, speed, and accuracy of the procedure and significantly decreased complications.