Affordable Access

Access to the full text

Renal arteriovenous fistula after retrograde ureteroscopic lithotripsy for the lower ureteral stones: a rare case report

  • Liu, Wan-Zhang1
  • Huang, Ting1
  • Fang, Li1
  • Cheng, Yue1
  • 1 NingBo First Hospital, NingBo Hospital of ZheJiang University, #59 Liuting Street, NingBo City, Zhejiang Province, 315000, China , NingBo City (China)
Published Article
BMC Urology
Springer (Biomed Central Ltd.)
Publication Date
Aug 15, 2020
DOI: 10.1186/s12894-020-00688-1
Springer Nature


BackgroundRenal arteriovenous fistula was rarely reported in retrograde endoscopic procedure. Up to now, there is still an absence of report on the formation of renal arteriovenous fistula after semi-rigid ureteroscopic lithotripsy for lower ureteral stones.Case presentationAn 83-year-old man was admitted to our hospital complaining about intermittent left flank pain that had persisted for 1 week. He suffered medium hypertension and nephrolithiasis treated with left open ureterolithotomy and two ureteroscopic lithotripsies. Non-contrast abdominal CT scan revealed two left lower ureteral stones diametered 8 mm and 7 mm respectively with mild hydronephrosis. A retrograde semi-rigid ureteroscopic lithotripsy was performed to remove the stones, after which two Double-J stents were placed for the ureteral stricture. Due to the continuous gross hematuria and hemoglobin droppings 2 days after operation, a variety of conservative therapies, including blood transfusion and bed rest, were adopted. Then, the patient was discharged with a stable hemoglobin. However, he presented himself to our emergency department with aggravating left flank pain and severe gross hematuria as little as 2 days later. Emergent digital subtraction angiography was conducted to reveal an arteriovenous fistula in the left kidney, which was embolized with two platinum coils to stop the bleeding. His hematuria was resolved in 3 days, and two Double-J stents were removed in 4 weeks. The patient was followed up for 1 year, during which no hematuria or flank pain recurred.ConclusionThis is the first case report on the formation of renal arteriovenous fistula after semi-rigid ureteroscopic lithotripsy. In this case, elevated intrapelvic pressure, historical surgery and hydronephrosis might be associated with the primary risk of the complication.

Report this publication


Seen <100 times