A patient with a history of total cystectomy for bladder cancer, cutaneous ureterostomy, irradiation, and long-term indwelling urinary catheters presented with an aortoureteral fistula (UAF), which was treated with an endoureteral stent graft. The described ureteral approach using stent grafts may be considered for the management of UAFs when more traditional approaches are unavailable.
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Article Synopsis
- - A lack of guidelines for managing ureteroarterial fistula (UAF) following ileal conduit urinary diversion leads this study to explore clinical presentation, causes, and treatment options through a review of existing literature, which included 32 studies on 40 patients.
- - The review found that UAF mostly occurs unilaterally (95% of cases) and is commonly linked to factors like female sex, chronic ureteral stent placement, and past pelvic surgeries or radiation.
- - When comparing treatment methods, combined endovascular and endoureteral approaches showed similar outcomes to traditional surgery regarding mortality and complication rates, but they had lower stent-graft infection rates, highlighting the need for close monitoring post-procedure
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