Severe hematuria after transurethral electrocoagulation in a patient with an arteriovesical fistula
1 Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, 79# Qingchun Road, Hangzhou 310003, Zhejiang Province, China
2 Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
3 Department of Urology, China-Japan Friendship Hospital, Beijing 100029, China
BMC Urology 2013, 13:68 doi:10.1186/1471-2490-13-68Published: 1 December 2013
Arteriovesical fistulas are extremely rare. Only eleven cases were previously reported in the literature. They can occur iatrogenically, traumatically or spontaneously.
We report an unusual case of a 62-year-old woman with arteriovesical fistula that developed fatal hematuria after transurethral electrocoagulation. Computed tomography (CT) and selective angiography revealed a pseudoaneurysm of the right superior vesical artery with arteriovesical fistula formation, which was managed by transarterial embolization.
Contrast enhanced CT or CT angiography should be performed when a pulsatile hemorrhage is revealed during cystoscopy. Therapeutic vesical arterial embolization should be considered as a safe and effective procedure for arteriovesical fistulas. Transurethral electrocoagulation may cause severe hematuria for pulsatile bladder bleeding in patients with pelvic vascular malformation.