Takahashi Akira, Nishiyama Ryuichi, Kitahara Mitsuteru, Hiura Masaru, Kanaoka Toshio, Hayashi Tadashi, Hyotani Genhachi, Matsuo Yukinori, Tsutsui Kazushige
Department of Urology, Japanese Red Cross Society, Wakayama Medical Center.
Hinyokika Kiyo. 2004 Jan;50(1):53-5.
A 71-year-old woman who had undergone a total abdominal hysterectomy and pelvic irradiation for cervical cancer and fecal diversion for adhesive ileus was referred to us for a "left" ureteral stone and intermittent gross hematuria. Bilateral ureteral stents had been indwelled because of lower ureteral strictures for a long time. Hematuria continued after the removal of the ureteral stone, and she once went into hypovolemic shock at the time of exchange of the right ureteral catheter. Selective arteriography revealed a "right" ueteroarterial fistula. Endovascular management alone failed to resolve the fistula, but a subsequent transurethral metal coil embolization was effective, and the hematuria was relieved. She is still free from disease at 7-month followup. As far as we know, there has been no previous report of a transurethrally managed ureteroarterial fistula.
一名71岁女性因宫颈癌接受了全腹子宫切除术及盆腔放疗，因粘连性肠梗阻进行了粪便转流，因“左侧”输尿管结石和间歇性肉眼血尿转诊至我院。由于输尿管下段长期狭窄，双侧输尿管支架已留置。输尿管结石取出后血尿仍持续，右侧输尿管导管更换时她曾发生低血容量性休克。选择性动脉造影显示“右侧”输尿管动脉瘘。单纯血管内治疗未能解决瘘管问题，但随后的经尿道金属线圈栓塞有效，血尿得到缓解。7个月随访时她仍无疾病复发。据我们所知，此前尚无经尿道治疗输尿管动脉瘘的报道。
