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Uretero-arterial fistulae Diagnostic and therapeutic management Volume 18, issue 10, Décembre 2006

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Authors
Service de Chirurgie Vasculaire, CHU Pitié-Salpêtrière, 75651 Paris cedex 13

Uretero-iliac fistulae are rare complications, the incidence of which seems to be on the increase. The diagnosis should be suspected in cases of massive haematuria in patients with a previous history of surgery for abdominal cancer and/or abdomino-pelvic irradiation. Their treatment requires both a vascular and an urological approach. Multiple therapeutic options are available inboth specialties from conventional surgical intervention (in situ or extra-anatomical arterial repaire, nephrectomy) to less invasive endovascular (obliteration or iliac repair by stending) and endo-ureteral procedures (ureteral stent, percutancous nephrestomy). The best results are obtained, considering the general physical condition of the patients, with early diagnosis and appropriate choice of treatment.