Abstract
A vascular-urinary fistula is defined as a confirmed abnormal passageway between any vascular structure and any part of the urinary tract. Arterio-ureteral fistula is the most common type. Risk factors for developing this condition include previous pelvic radiation or surgery, vascular surgery or stenting, and indwelling ureteral stents. An increase in the incidence has been suggested. In patients with unexplained hematuria, this condition should be included in the differential diagnosis. Hematuria can either present as intermittent microscopic symptoms or as life-threatening gross hematuria. Awareness of the possibility of this condition, and knowledge of the underlying risk factors, could avoid delay of the diagnosis. Angiography or ureteral contrast studies confirmed the diagnosis most frequently, especially when active bleeding is present or excited by manipulation, although laparotomy has been often described when diagnosis remained uncertain. Endovascular treatment is the primary therapy of first choice.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kamphorst K, Lock TMTW, van den Bergh RCN, Moll FL, de Vries J-PPM, Lo RTH, de Kort GAP, Bruijnen RCG, Dik P, Horenblas S, de Kort LMO. Arterio-ureteral fistula: systematic review of 445 patients. J Urol. 2021; https://doi.org/10.1097/JU.0000000000002241.
Bergqvist D, Pärsson H, Sherif A. Arterio-ureteral fistula—a systematic review. Eur J Vasc Endovasc Surg. 2001;22(3):191–6. https://doi.org/10.1053/ejvs.2001.1432.
Krambeck AE, DiMarco DS, Gettman MT, Segura JW. Ureteroiliac artery fistula: diagnosis and treatment algorithm. Urology. 2005;66(5):990–4. https://doi.org/10.1016/j.urology.2005.05.036.
Lock MTWT, Kamphorst K, van den Bergh RCN, Moll FL, de Vries JPM, Lo RTH, de Kort GAP, Bruijnen RCG, Dik P, Horenblas S, de Kort LMO. Arterio-ureteral fistula: a nationwide cross-sectional questionnaire analysis. World J Urol. 2021;40(3):831–9. https://doi.org/10.1007/s00345-021-03910-3.
Campschroer T, Lock M, Bosch J. Acucise® endoureterotomy: a forgotten treatment option in ureteral strictures of benign origin between the ureteropelvic and ureterovesical junctions; long-term results. Urol Nephrol Open Access J. 2015;2(1) https://doi.org/10.15406/unoaj.2015.02.00025.
Lopes RI, Torricelli FCM, Gomes CM, Carnevale F, Bruschini H, Srougi M. Endovascular repair of a nearly fatal iliac artery injury after endoureterotomy. Scand J Urol. 2013;47(5):437–9. https://doi.org/10.3109/21681805.2013.766902.
Wagner JR, D’Agostino R, Babayan RK. Renal arterioureteral hemorrhage: a complication of acucise endopyelotomy. Urology. 1996;48(1):139–41. https://doi.org/10.1016/s0090-4295(96)00107-0.
Davidson OW, Smith RP. Uretero-Arterial Fistula: Report of a Case. Journal of Urology. 1939;42(2):257–62. http://www.jurology.com. https://doi.org/10.1016/S0022-5347%2817%2971514-5.
Hamer HG. “Fatal ureteral hemorrhage due to erosion into the iliac artery: report of a case occurring during indwelling catheter drainage for pyelitis of pregnancy.” Trans Am Assoc Genito-Urin Surg. 1939;32:177–83.
Taylor WmN, Reinhart HL. Mycotic Aneurism of Common Iliac Artery with Rupture into Right Ureter: Report of a Case. J Urol [Internet]. 1939;42(1):21–6. http://www.jurology.com. https://doi.org/10.1016/S0022-5347%2817%2971480-2.
van den Bergh RCN, Moll FL, de Vries J-PPM, Lock TMTW. Arterioureteral fistulas: unusual suspects-systematic review of 139 cases. Urology. 2009;74(2):251–5. https://doi.org/10.1016/j.urology.2008.12.011.
Awakura Y, Yamamoto M, Fukuzawa S, Okuno H, Hashimura T, Fukuyama T, Otani T, Tuchiya N, Koizumi K. [A case of uretero-aortic fistula]. Hinyokika Kiyo. 1997;43(4):299–301. Acta urologica Japonica.
Vandersteen DR, Saxon RR, Fuchs E, Keller FS, Taylor LMJ, Barry JM. Diagnosis and management of ureteroiliac artery fistula: value of provocative arteriography followed by common iliac artery embolization and extraanatomic arterial bypass grafting. J Urol. 1997;158(3 Pt 1):754–8.
Kajaia D, Hager B, Heidorn T, Schneider H, Weingärtner K, Zugor V. Uretero-iliac artery fistula as a urological emergency. Aktuelle Urol. 2020; https://doi.org/10.1055/a-1180-0191.
Palmerola R, Westerman ME, Fakhoury M, Boorjian SA, Richstone L. Ureteroarterial fistulas after robotic and open radical cystectomy. J Endourol Case Rep. 2016;2(1):48–51. https://doi.org/10.1089/cren.2015.0034.
Perrenoud AL, Heiberger G, Shriver J, Yim D. Endoleak and pseudoaneurysm formation in the setting of stent graft infection following endovascular uretero-arterial fistula repair: the dreaded complication. Cureus. 2020;12(6):e8830. https://doi.org/10.7759/cureus.8830.
Simon B, Neubauer J, Schoenthaler M, Hein S, Bamberg F, Maruschke L. Management and endovascular therapy of ureteroarterial fistulas: experience from a single center and review of the literature. CVIR Endovasc. 2021;4(1):36. https://doi.org/10.1186/s42155-021-00226-6.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Lock, T.M.T.W., Kamphorst, K., Moll, F.L., van den Bergh, R.C.N. (2022). Vascular-Urinary Fistula. In: Sotelo, R., Polotti, C.F., Arriaga, J. (eds) Urinary Fistula. Springer, Cham. https://doi.org/10.1007/978-3-031-15317-4_9
Download citation
DOI: https://doi.org/10.1007/978-3-031-15317-4_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-15316-7
Online ISBN: 978-3-031-15317-4
eBook Packages: MedicineMedicine (R0)