Ishii Makoto, Nakata Wataru, Horibe Yuki, Tsujimura Go, Tsujimoto Yuichi, Nin Mikio, Tsujihata Masao
Departments of Urology Osaka Rosai Hospital Sakai City Osaka Japan.
IJU Case Rep. 2021 Sep 7;5(1):5-8. doi: 10.1002/iju5.12368. eCollection 2022 Jan.
Repeated urinary retention due to clots caused by congenital renal arteriovenous malformation is rare.
A 40-year-old woman (case 1) and a 66-year-old man (case 2) experienced recurrent urinary retention due to clots. Neither patient had a history of renal trauma nor was taking any medications. Contrast-enhanced abdominal computed tomography revealed a large hematoma in the renal pelvis and ureter with no masses, stones, or vascular lesions and only dilated blood vessels in the arterial phase in case 1. Angiography of the kidney in both patients revealed an arteriovenous malformation, and embolization of the arteries feeding the arteriovenous malformation was performed. Soon after embolization, hematuria disappeared completely with no recurrence for 5 years in case 1 and 2 years in case 2.
Congenital renal arteriovenous malformation should be considered as a cause of recurrent clot retention, and angiographic embolization of the feeding arteries can be an effective treatment.
先天性肾动静脉畸形导致的血凝块引起反复尿潴留较为罕见。
一名40岁女性(病例1)和一名66岁男性(病例2)因血凝块出现反复尿潴留。两名患者均无肾外伤史,也未服用任何药物。腹部增强计算机断层扫描显示肾盂和输尿管有一个大血肿,无肿块、结石或血管病变,病例1在动脉期仅有扩张的血管。两名患者的肾脏血管造影均显示有动静脉畸形,并对供应动静脉畸形的动脉进行了栓塞。栓塞后不久,病例1的血尿完全消失,5年未复发,病例2则为2年。
先天性肾动静脉畸形应被视为反复血凝块潴留的原因之一,对供血动脉进行血管造影栓塞可能是一种有效的治疗方法。