Early diagnosis and management of arterio-ureteral fistulas: A literature review
Objectives: Arterio-ureteralfistula (AUF) is an infrequent but potentially life-threatening condition. The aim of this study was reviewing the literature to build a flow-chart useful for an early and effective diagnosis and treatment of this pathology. Materials and methods: A literature search in Pu...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2023-02-01
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| Series: | Archivio Italiano di Urologia e Andrologia |
| Subjects: | |
| Online Access: | https://www.pagepressjournals.org/index.php/aiua/article/view/10928 |
| _version_ | 1797900237656817664 |
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| author | Pier Paolo Prontera Carmine Sciorio Antonio De Cillis Evangelista Martinelli Francesco Schiralli Marco Lattarulo Angelo D'Elia Emanuele Utano Francesco Saverio Grossi |
| author_facet | Pier Paolo Prontera Carmine Sciorio Antonio De Cillis Evangelista Martinelli Francesco Schiralli Marco Lattarulo Angelo D'Elia Emanuele Utano Francesco Saverio Grossi |
| author_sort | Pier Paolo Prontera |
| collection | DOAJ |
| description |
Objectives: Arterio-ureteralfistula (AUF) is an infrequent but potentially life-threatening condition. The aim of this study was reviewing the literature to build a flow-chart useful for an early and effective diagnosis and treatment of this pathology.
Materials and methods: A literature search in PubMed was con-ducted. In addition, retrieved articles were cross-referenced. Data parameters included oncologic, vascular and urological history, diagnostics, treatment, and follow up were collected using a standard template by 2 independent reviewers. Results: A total of 140 cases of AUF out of 172 available in the literature at the time of the review, were considered. All patients presented gross hematuria. Chronic indwelling ureteral catheter (CIUC); history of pelvic surgery (HPS) and history of pelvic radiotherapy (HRT) were present respectively in 81%, 62.1%and 58.6% of the sample. The most predominant location of AUF was at the common iliac artery ureteral crossing. Angiography with provocative measures had the highest diag-nostic sensitivity (50%) and endovascular treatment with stent-graft placement across the fistula is the current state of the art treatment choice.
Conclusions: Failure to diagnose can postpone a potentially life-saving targeted therapy and lead to complications. The identifi-cation of the Trifecta hematuria, history of pelvic surgery (HPS) and history of pelvic radiotherapy (HPR) would allow the identi-fication of patients at high risk of AUF, who may benefit from more sensitive early diagnostic investigations such as CT angiography and provocative angiography. The treatment of choice in case of AUF to date consist in endovascular prosthesis placement.
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| first_indexed | 2024-04-10T08:42:48Z |
| format | Article |
| id | doaj.art-aa633c88aa464035bb1def70712c3994 |
| institution | Directory Open Access Journal |
| issn | 1124-3562 2282-4197 |
| language | English |
| last_indexed | 2024-04-10T08:42:48Z |
| publishDate | 2023-02-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Archivio Italiano di Urologia e Andrologia |
| spelling | doaj.art-aa633c88aa464035bb1def70712c39942023-02-22T22:42:21ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972023-02-0110.4081/aiua.2023.10928Early diagnosis and management of arterio-ureteral fistulas: A literature reviewPier Paolo Prontera0Carmine Sciorio1Antonio De Cillis2Evangelista Martinelli3Francesco Schiralli4Marco Lattarulo5Angelo D'Elia6Emanuele Utano7Francesco Saverio Grossi8Department of Urology, “S.S. Annunziata” Hospital, TarantoDepartment of Urology, “Alessandro Manzoni” Hospital, LeccoDepartment of Urology, “S.S. Annunziata” Hospital, TarantoDepartment of Urology, “S.S. Annunziata” Hospital, TarantoDepartment of Urology, “S.S. Annunziata” Hospital, TarantoDepartment of Urology, “S.S. Annunziata” Hospital, TarantoDepartment of Urology, “S.S. Annunziata” Hospital, TarantoDepartment of Urology, “S.S. Annunziata” Hospital, TarantoDepartment of Urology, “S.S. Annunziata” Hospital, Taranto Objectives: Arterio-ureteralfistula (AUF) is an infrequent but potentially life-threatening condition. The aim of this study was reviewing the literature to build a flow-chart useful for an early and effective diagnosis and treatment of this pathology. Materials and methods: A literature search in PubMed was con-ducted. In addition, retrieved articles were cross-referenced. Data parameters included oncologic, vascular and urological history, diagnostics, treatment, and follow up were collected using a standard template by 2 independent reviewers. Results: A total of 140 cases of AUF out of 172 available in the literature at the time of the review, were considered. All patients presented gross hematuria. Chronic indwelling ureteral catheter (CIUC); history of pelvic surgery (HPS) and history of pelvic radiotherapy (HRT) were present respectively in 81%, 62.1%and 58.6% of the sample. The most predominant location of AUF was at the common iliac artery ureteral crossing. Angiography with provocative measures had the highest diag-nostic sensitivity (50%) and endovascular treatment with stent-graft placement across the fistula is the current state of the art treatment choice. Conclusions: Failure to diagnose can postpone a potentially life-saving targeted therapy and lead to complications. The identifi-cation of the Trifecta hematuria, history of pelvic surgery (HPS) and history of pelvic radiotherapy (HPR) would allow the identi-fication of patients at high risk of AUF, who may benefit from more sensitive early diagnostic investigations such as CT angiography and provocative angiography. The treatment of choice in case of AUF to date consist in endovascular prosthesis placement. https://www.pagepressjournals.org/index.php/aiua/article/view/10928Hematuria; Stents; Urinary fistula; Arterioureteral fistula; Endovascular procedures; Angiography. |
| spellingShingle | Pier Paolo Prontera Carmine Sciorio Antonio De Cillis Evangelista Martinelli Francesco Schiralli Marco Lattarulo Angelo D'Elia Emanuele Utano Francesco Saverio Grossi Early diagnosis and management of arterio-ureteral fistulas: A literature review Archivio Italiano di Urologia e Andrologia Hematuria; Stents; Urinary fistula; Arterioureteral fistula; Endovascular procedures; Angiography. |
| title | Early diagnosis and management of arterio-ureteral fistulas: A literature review |
| title_full | Early diagnosis and management of arterio-ureteral fistulas: A literature review |
| title_fullStr | Early diagnosis and management of arterio-ureteral fistulas: A literature review |
| title_full_unstemmed | Early diagnosis and management of arterio-ureteral fistulas: A literature review |
| title_short | Early diagnosis and management of arterio-ureteral fistulas: A literature review |
| title_sort | early diagnosis and management of arterio ureteral fistulas a literature review |
| topic | Hematuria; Stents; Urinary fistula; Arterioureteral fistula; Endovascular procedures; Angiography. |
| url | https://www.pagepressjournals.org/index.php/aiua/article/view/10928 |
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