Kidney and Urinary Disease

Genitourinary interventions are used to treat urinary tract problems that block the flow of urine from the kidneys and bladder. They may be used to:

  • Relieve blockages in the ureters — the long tubes that carry urine from the kidneys to the bladder. The blockages can affect one or both kidneys and are caused by medical conditions including tumors, infections, kidney stones and blood clots.
  • Drain urine directly from the bladder to treat urinary incontinence (leakage) or urinary retention (not being able to urinate) caused by conditions such as prostate enlargement (cancer, benign prostatic hypertrophy).

At University Radiology, our interventional radiologists offer several image-guided, minimally invasive treatment options to relieve urinary problems. The treatments often take advantage of special imaging technologies such as ultrasound as well as fluoroscopy, which uses X-rays to create real-time, moving images of structures inside the body. Treatment options include:

Ureteral stenting

During ureteral stenting, a soft plastic tube (called a stent) is inserted into the ureter. Urine flows through the tube — bypassing a blockage — and into the bladder.

What are the benefits?
  • Restores urine flow through to the bladder and allows the kidneys to function normally.
  • Helps prevent permanent damage to the kidneys from urine retention and infection.
  • The stent can remain in place for several months before being removed or replaced.
How does the procedure work?

During ureteral stenting, your interventional radiologist makes a small opening in the skin near the kidney. With the guidance of ultrasound and fluoroscopy, he or she threads a guide wire into the ureter. The stent slides over the guide wire and is placed into the ureter. The procedure can be performed under moderate sedation, and frequently takes 1 hour.
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Nephrostomy

Nephrostomy involves the placement of a small, flexible tube (called a catheter) through the skin and into the kidney to drain urine. The tube is then connected to either an external drainage bag or, less frequently, directly to the bladder.

What are the benefits?
  • Relieves the blockage of urine flow and allows the kidneys to function normally.
  • Helps prevent permanent damage to the kidneys from urine retention and infection.
  • Nephrostomy is an option when it is not possible to place a ureteral stent.
How does the procedure work?

Your interventional radiologist inserts a guide wire through a small opening in the skin and uses ultrasound and fluoroscopy to direct the wire into the kidney. A catheter, which is a long, thin plastic tube, less than the diameter of a typical pencil, is inserted over the guide wire and into the kidney. The catheter is most often connected to a bag outside of the body that collects urine. It is left in place until a ureteral stent can be placed or the blockage in the ureter is relieved. The procedure can be performed under moderate sedation, and frequently takes 1 hour.
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Suprapubic catheterization

A suprapubic catheter is a tube that drains urine directly from the bladder into a bag outside of the body. The catheter is inserted into the bladder below the belly button and above the pubic bone.

What are the benefits?
  • Relieves pressure from urinary retention in the bladder.
  • Can help patients who cannot have or were unsuccessful with a urethral catheter — a catheter placed directly into the urethra.
  • The catheter can remain in place several weeks before being removed or replaced.
How does the procedure work?

Your interventional radiologist uses an ultrasound machine to precisely locate the position of the bladder. Through a small incision, just above the pubic bone, he or she inserts a catheter — a small, soft plastic tube using fluoroscopy guidance. Once the catheter is in the bladder, a small balloon is inflated to hold it in place. The catheter drains into a bag outside of the body. The procedure can be performed under moderate sedation, and frequently takes 1 hour.
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