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Open Access Case report

Severe hematuria after transurethral electrocoagulation in a patient with an arteriovesical fistula

Xiangyi Zheng1, Yiwei Lin1, Bin Chen1, Xianyong Zhou2, Xiaofeng Zhou3, Yuehong Shen1* and Liping Xie1

Author Affiliations

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

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BMC Urology 2013, 13:68  doi:10.1186/1471-2490-13-68

Published: 1 December 2013

Abstract

Background

Arteriovesical fistulas are extremely rare. Only eleven cases were previously reported in the literature. They can occur iatrogenically, traumatically or spontaneously.

Case presentation

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.

Conclusions

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.

Keywords:
Hematuria; Arteriovesical fistula; Vesical pseudoaneurysm