Urethral pseudoaneurysm life-threatening bleeding: a case report and literature review of etiological and treatment options

Abstract

Background Pseudoaneurysm (PA) of pudendal artery’s distal branches is an extremely rare clinical scenario. We report a case of life-threatening urethrorrhagia due to PA of the internal pudendal artery (IPA). Case presentation A 35-year-old man presented with massive urethral bleeding after traumatic urethral catheterization. Failed attempts of conservative management necessitate an emergency intervention with angiography which shows an active extravasation from the left IPA, which was embolized with gel foam, and complete hemostasis was achieved. Conclusion PA of the pudendal artery’s distal branches is serious, and majority of cases need an emergency intervention. CT angiography is the best diagnostic imaging, and angioembolization of the bleeding site is considered the first-line treatment. Other treatment options such as US-guided compression, endoscopic coagulation, and open surgery are alternative treatments.