Ureteroarterial Fistulas: Diagnosis, Management, and Clinical Evolution

Ann Vasc Surg. 2017 Oct:44:459-465. doi: 10.1016/j.avsg.2017.05.001. Epub 2017 May 8.

Abstract

Background: Ureteroarterial fistulas (UAFs) have a low incidence but are a potentially fatal cause of hematuria. Initially treated by open surgery, endovascular techniques have decreased potential complications.

Material and methods: We present a short series of UAFs (n = 5) treated in our institution in the last 10 years: 1 case showed up after aorta-iliac bypass surgery, 1 case after endovascular aortic repair and embolization of right hypogastric artery, and 3 cases after oncological surgeries. We review the published literature via PubMed.

Results: The different approaches (2 open and 3 endovascular procedures) were based on the clinical situation of the patients and on technical limitations. Three patients died after the procedure (2 after open surgery and 1 after endovascular treatment). In our institution, endovascular treatment showed good results in terms of early complications and associated mortality compared with open surgery.

Conclusions: UAF is a rare but a potentially fatal complication in patients with predisposing factors. No long-term follow-up has been published to assess the possible complications arising from the technique, such as prosthetic infection. No antibiotic treatment protocols have been established, so long-term follow-up is necessary to determine late complications.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Computed Tomography Angiography
  • Endovascular Procedures*
  • Fatal Outcome
  • Female
  • Hematuria / etiology
  • Humans
  • Male
  • Middle Aged
  • Risk Factors
  • Spain
  • Time Factors
  • Treatment Outcome
  • Ureteral Diseases / diagnostic imaging
  • Ureteral Diseases / etiology
  • Ureteral Diseases / surgery*
  • Urinary Fistula / diagnostic imaging
  • Urinary Fistula / etiology
  • Urinary Fistula / surgery*
  • Vascular Fistula / diagnostic imaging
  • Vascular Fistula / etiology
  • Vascular Fistula / surgery*
  • Vascular Surgical Procedures*