Arterioureteral Fistulas: Unusual Suspects—Systematic Review of 139 Cases

An arterioureteral fistula (AUF) is a rare but life-threatening condition bordering on the expertise of the urologist, vascular surgeon, and interventional radiologist. We reviewed published cases in order to better recognize and treat patients with an AUF. Of all 139 patients, 13% died of an AUF-related cause; in this group, only 22% of the fistulas were recognized before treatment. The diagnosis AUF should be considered in patients with unexplained hematuria who have a history of pelvic cancer or vascular surgery. Angiography and ureteral contrast studies most often confirmed AUFs. Patients treated with endovascular technique had the most favorable outcome.