Ureteroarterial fistulas after radical pelvic surgery: pathogenesis, diagnosis, and therapeutic modalities

Escobar, PF; Howard, JL; Kelly, John D.; Py, Roland; Grendys, EC; De, Dosoretz; Orr, Jr Jw

doi:10.1111/j.1525-1438.2007.01079.x

Cited by 22 publications

(17 citation statements)

References 21 publications

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“…The patient described in this report had chronic indwelling stents and previous radiation therapy to the pelvis. The constant pulsation of the iliac artery is transmitted to a very compromised ureter (hydroureteronephrosis, infection, pelvic surgery, hypotension, and finally left hydroureter) resulting a pressure necrosis, most likely where the ureter crosses the iliac artery [3, 4]. To avoid fistula formation in debilitated patients treated previously with radiation and surgery, the use of small and soft stents is recommended [5].…”

Section: Discussionmentioning

confidence: 99%

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Ureteroiliac Artery Fistula in a Young Woman with Short Bowel Syndrome for Radiation Enteritis

Santarpia¹,

Creta

Bracale

et al. 2010

Case Reports in Medicine

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Ureteral-iliac artery fistula is a rare and potentially life-threatening complication, typically occurring after radiation therapy in already surgically treated cancer patients. This case report describes the diagnostic challenges and the successful management, with the positioning of an intra-arterial prosthesis, of a fistula between the internal iliac artery and the left ureter presenting as massive hematuria in a young woman with history of total colectomy and pelvic radiotherapy for rectal cancer and subsequent wide ileal resections and bilateral ureteral stent positioning for radiation enteritis. Ureteroiliac artery fistulas require a prompt diagnosis and intervention, to avoid life threatening clinical events.

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Section: Discussionmentioning

confidence: 99%

“…The treatment of these fistulae has also changed overtime, from open surgery to stent-graft repair, which is less invasive than the open approach [4–6]. …”

Section: Discussionmentioning

confidence: 99%

Ureteroiliac Artery Fistula in a Young Woman with Short Bowel Syndrome for Radiation Enteritis

Santarpia¹,

Creta

Bracale

et al. 2010

Case Reports in Medicine

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“…The exact incidence is not known, however it seems increasing in the last years [1]. This is most likely due to the increased use of long-term ureteral stenting, pelvic radiation and due to longer survival in patients after treatment for pelvic tumors [2]. …”

Section: Discussionmentioning

confidence: 99%

“…The major problem is that fistula diagnosis is often delayed because of the intermittent nature of the condition and the difficulty in confirming fistulous communication [2]. Massive hematuria with hypotension and shock is uncommon but is reported [5].…”

Section: Discussionmentioning

confidence: 99%

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Ureteroiliac fistula: a case report review of the literature

Mitterberger

Frauscher

Steppan³

et al. 2009

Cases J

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IntroductionUreteroiliac fistulas are rare but potentially life-threatening. Risk factors to develop a fistula are chronic indwelling ureteral stents, previous pelvic surgery and radiotherapy.Case presentationWe report a case of a patient with intermittent gross hematuria after previous abdominal surgery, radiotherapy and indwelling ureteric stents. After several diagnostic and therapeutic procedures an ureteroiliac fistula could be finally identified and treated by endovascular stenting.ConclusionUreteroiliac fistula should be considered in any patient with intermittent gross hematuria and any of the known risk factors.

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Molecular mechanisms involved in the protective effect of the chloroform extract of Selaginella lepidophylla (Hook. et Grev.) Spring in a lithiasic rat model

et al. 2013

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Urolithiasis is a multifaceted process, progressing from urine supersaturation to the formation of mature renal calculi. Calcium oxalate, the main component of kidney stones, has toxicological effects on renal epithelial cells. Some medicinal plants have shown pharmacological effects against renal lithiasis, such as Selaginella lepidophylla (Hook. et Grev) Spring, a plant empirically used in Mexico for its diuretic and antilithiasic activity. The plant was identified and ground, and a chloroform extract (CE) was obtained. Urolithiasis was induced in Wistar female rats by administration of ethylene glycol and ammonium chloride for 21 days. Urolithiasis rats were treated with the CE (50 mg/kg) for 21 days. Osmolality, creatinine, sodium and potassium concentrations were measured in blood and urine. Glomerular filtration rate (GFR), and electrolytic and water balances were calculated. Urinary oxalic acid concentration was measured. Apoptosis, lipoperoxidation, ROS and p-amino hippuric acid were determined in cortical tissue. Urolithiasis rats showed a decrease of urinary flow, GFR, electrolytic balance, renal tubular secretion and ATP concentration and increase of urinary oxalic acid, lipoperoxidation, oxidative stress and apoptosis in cortical tissue. After treatment with the CE, urinary flow rate, GFR and renal tubular secretion levels were recovered; on the other hand, serum creatinine and urinary oxalic acid decreased on day 21. CE of Selaginella lepidophylla prevented the damage caused by lithiasic process by improving the active secretion in the proximal tubules, counteracting the ROS and lipoperoxidation effects by oxalate and decreased the OAT3 expression on kidney.

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Ureteroarterial fistulas after radical pelvic surgery: pathogenesis, diagnosis, and therapeutic modalities

Cited by 22 publications

References 21 publications

Ureteroiliac Artery Fistula in a Young Woman with Short Bowel Syndrome for Radiation Enteritis

Ureteroiliac Artery Fistula in a Young Woman with Short Bowel Syndrome for Radiation Enteritis

Ureteroiliac fistula: a case report review of the literature

Molecular mechanisms involved in the protective effect of the chloroform extract of Selaginella lepidophylla (Hook. et Grev.) Spring in a lithiasic rat model

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