Uretero-aortic fistula: A case report of a serious complication of indwelling ureteral catheter

Abstract

We present a case of a uretero-aortic fistula assumed to be caused by an indwelling ureteral catheter. A 65-year-old male who underwent cystectomy and ureterocutaneostomy with bilateral ureteral stents had been well until gross hematuria from the left catheter developed. In spite of a through radiological examination of the left kidney, no abnormal findings were noted. However, massive hemorrhage was encountered on catheter exchange, prompting us to suspect a formation of a uretero-arterial fistula. CT scan was performed again, demonstrating severe adhesion between the left ureter and the aorta at the crossing point. At exploration, a fistula of about 7 mm between the left ureter and anterior surface of the aorta was recognized. Left nephro-ureterectomy and closure of the aortic fistula with a rectus muscle fascia wrapping was successfully performed. His postoperative course was uneventful. Because the continued increase in the utilization of ureteral catheters could cause frequent occurrence of this condition, urologists should be aware of a uretero-arterial fistula as possible serious complication of indwelling ureteral catheters.