Refractory Urinary Fistula With Infundibular Stenosis After Partial Nephrectomy

A 71-year-old male patient who was diagnosed with renal cell carcinoma (cT1aN0M0) underwent a laparoscopic left partial nephrectomy. Because the bleeding could not be controlled, conversion to laparotomy was instigated. A ureteral stent was placed on confirmation of postoperative urine leakage from the drain, but the volume of drainage did not decrease. The findings of retrograde pyelography and computed tomography showed a urinary fistula resulting from isolated calyces caused by infundibular stenosis, for which transurethral dilatation for the stenosis was carried out. However, owing to the severity of stenosis, the guidewire was unable to achieve passage, and endoscopic dilatation was abandoned. Selective embolization of the left renal artery was then carried out. No drainage fluid was observed after embolization, and residual renal function of the left kidney was confirmed.