Combined Antegrade and Retrograde Access to Difficult Ureters: Revisiting the Rendezvous Technique

The senior author recently interviewed a urology resident at the end of training who expressed an interest in performing rendezvous type procedures which caused him some consternation. This “technique” which is different in every case, requires a dynamic adaptation to a sometimes changing surgical challenge, requiring knowledge and indeed the experience of every variety of endourological device and indications for their use.

Informed consent and early shared decision making are key to a satisfactory outcome with these complex cases as the failure, both immediate and long-term is well documented but the technique may offer the patient a relief from the unpleasantness of nephrostomy drainage.

Be realistic with your patients if you are contemplating this approach to the ureteric obstruction which has limited indications.

Written by: Stephen R Keoghane, MBBS MS FRCS, Consultant Urological Surgeon, Departments of Urology and Radiology, West Suffolk NHS Foundation Trust, Portsmouth and Bury St Edmunds, Suffolk, UK. SK Deverill, Departments of Urology and Radiology, Portsmouth NHS Trust, Portsmouth, UK.

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