Department of Urology, University Medical Centre Utrecht, P.O. BOX 85500, 3508 GA, Utrecht, The Netherlands.
Department of Urology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
World J Urol. 2022 Mar;40(3):831-839. doi: 10.1007/s00345-021-03910-3. Epub 2022 Jan 22.
Arterio-ureteral fistula (AUF) is an uncommon diagnosis, but potentially lethal. Although the number of reports has increased over the past two decades, the true incidence and contemporary urologists' experience and approach in clinical practice remains unknown. This research is conducted to provide insight in the incidence of AUF in The Netherlands, and the applied diagnostic tests and therapeutic approaches in modern practice.
A nationwide cross-sectional questionnaire analysis was performed by sending a survey to all registered Dutch urologists. Data collection included information on experience with patients with AUF; and their medical history, diagnostics, treatment, and follow-up, and were captured in a standardized template by two independent reviewers. Descriptive statistics were used.
Response rate was 62% and 56 AUFs in 53 patients were reported between 2003 and 2018. The estimated incidence of AUF in The Netherlands in this time period is 3.5 AUFs per year. Hematuria was observed in all patients; 9% intermittent microhematuria, and 91% presenting with, or building up to massive hematuria. For the final diagnosis, angiography was the most efficient modality, confirming diagnosis in 58%. Treatment comprised predominantly endovascular intervention.
The diagnosis AUF should be considered in patients with persistent intermittent or massive hematuria.
动静脉瘘（AUF）是一种罕见的诊断，但可能是致命的。尽管在过去的二十年中报告的数量有所增加，但真实的发病率以及当代泌尿科医生在临床实践中的经验和方法仍不清楚。本研究旨在提供荷兰 AUF 发病率的见解，以及现代实践中应用的诊断测试和治疗方法。
通过向所有注册的荷兰泌尿科医生发送问卷调查，进行了一项全国性的横断面问卷调查分析。数据收集包括与 AUF 患者的经验；以及他们的病史、诊断、治疗和随访信息，并由两名独立审查员在标准化模板中进行记录。采用描述性统计。
响应率为 62%，2003 年至 2018 年间报告了 53 例 56 例 AUF。在此期间，荷兰 AUF 的估计发病率为每年 3.5 例。所有患者均出现血尿；9%间歇性镜下血尿，91%表现为或发展为大量血尿。为了明确诊断，血管造影是最有效的检查方法，可确诊 58%的病例。治疗主要包括血管内介入。
对于持续间歇性或大量血尿的患者，应考虑 AUF 的诊断。
