Department of Urology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong Province, People's Republic of China.
Department of Urology, People's Hospital of Laoling, Laoling, Shandong Province, People's Republic of China.
BMC Urol. 2022 Jul 27;22(1):117. doi: 10.1186/s12894-022-01071-y.
Arterioureteral fistula (AUF) is a rare, life-threatening condition wherein communication occurs between a ureter and the common, internal, or external iliac artery. The sensitivity of common clinical imaging examination for AUF is low, which leads to a delayed diagnosis and increased mortality. In addition, the increased use of ureteral stents contributes to the growing frequency of AUF.
Our two patients were 74 and 65 years old males respectively. They both had a medical history of bladder cancer and underwent radical cystectomy with ureterocutaneostomy. The patients underwent routine catheter exchange during over 1 year postradical cystectomy and subsequently experienced intermittent gross pulsatile haematuria. After a series of imaging examinations failed to identify the cause, the patients were ultimately diagnosed with AUF and treated with interventional radiotherapy, followed by broad-spectrum antibiotics. Positive effects were found.
The incidence of AUF is increased with the prolongation of survival in patients with related risk factors. This case report aims to highlight early diagnosis and management of AUF to lower the mortality.
动静脉瘘（AUF）是一种罕见的、危及生命的疾病，其特征是输尿管与普通、内或外髂动脉之间发生沟通。AUF 的常见临床影像检查的敏感性较低，导致诊断延迟和死亡率增加。此外，输尿管支架的使用增加也导致 AUF 的发病率不断上升。
我们的两名患者分别为 74 岁和 65 岁男性，均有膀胱癌病史，并接受了根治性膀胱切除术和输尿管皮造口术。患者在根治性膀胱切除术后 1 年以上进行了常规导管更换，随后出现间歇性肉眼可见的搏动性血尿。一系列影像学检查未能明确病因后，患者最终被诊断为 AUF，并接受了介入放射治疗，随后使用广谱抗生素。结果发现治疗有效。
具有相关风险因素的患者的生存期延长，AUF 的发病率增加。本病例报告旨在强调 AUF 的早期诊断和治疗，以降低死亡率。
