Presented by: Joerg Neymeyer Dr.
Medical University Charite - Berlin - Department of Urology

Introduction

Arterio-ureteral fistulae are abnormal connections between blood vessels and the ureter and most commonly involve the iliac arteries and the ureter. They are rare entities, and only around 200 cases have been reported in the literature. However, the majority of fistulae are secondary, occurring due to radiation or surgery for urological and gynecological cancers, vascular or pelvic surgeries. Our procedure consents include a statement regarding the use of images such as radiographs without patient identifiers for teaching and illustrative purposes. Our institutional policy does not require patient consents for case reports. Case reports are also exempt from institutional board review.

Materials

We present 21 cases of arterio-ureteral fistulae that presented with lifethreatening hematuria. 11 patients were treated successfully with ureteral covered stent placement (Allium ureteral stent 200x9mm) and 10 patients are combined treated with uretral (Allium ureteral stent 200x9mm) and endovascular (Endovascular Stent Graft) covered stents placement. Mean surgery time was 55min (16- 95min). The position, continuity and sealing of the stent in the ureter and vessel were documented by radiological contrast imaging.

Results

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All patients were treated successfully with ureteral or with combined uretral and endovascular covered stent placement.

Conclusion

Conclusions: In conclusion, ureteral or with combined uretral and endovascular covered stent placement of covered stents is a feasible minimal invasive therapeutic option for the treatment of acute life-threatening hemorrhage due to arterio-uretral fistulae.

Funding

None

Lead Authors

Cubuk Alkan, MD
Kocaeli University Hospital

Viktoria Schaeff, Dr.
Medical University Charite - Berlin - Department of Urology

Sarah Wienberger, Dr.
Medical University Charite - Berlin - Department of Urology

Safwan Omran, Dr.
Medical University Charite - Berlin - Department of Vascular Surgery

Thorsten Schlomm, Prof. Dr.
Medical University Charite - Berlin - Department of Urology