Estimation of successful capping with complete aspiration of bladder via nephroureterostomy tube

Figure 2 An 83 years old male with prostate cancer presented with right hydroureteronephrosis from a tumor involving the right bladder base. Cystoscopic attempt at placing ureteral stent failed. The indication for drainage of kidney is to preserve renal function for chemotherapy. Prone position. A: Distal right ureteral obstruction is crossed and contrast is injected into the bladder by a 5 French directional catheter (arrow); B: A 10 F × 26 cm nephroureterostomy tube (NUT) is placed, and small amount of contrast is injected through the NUT to confirm proper positioning of the proximal loop. Retained contrast/urine in bladder (asterisk) is evident; and C: Retained contrast in bladder (asterisk) is completely aspirated via NUT. B and C are the final images of this intervention. The NUT was capped a few days later. It remained capped with no clinical issues for 42 d before it was converted to a ureteral stent.