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[Congenital pelvic arteriovenous fistula in a male. A case report]
H Mimata1, T Tanigawa, M Imagawa
1Department of Urology, Medical College of Oita.
Insights
Congenital arteriovenous fistula in the male pelvis is rare. This case highlights diagnosis and management challenges for pelvic AV fistulas involving the bladder, prostate, and rectum.
Area of Science:
- Urology
- Vascular Surgery
- Radiology
Background:
- Congenital arteriovenous fistulas (AV fistulas) are rare vascular malformations.
- Pelvic AV fistulas, particularly in males, are exceptionally uncommon.
- This case focuses on a congenital AV fistula in the true pelvis.
Observation:
- The patient presented with symptoms of pollakiuria (frequent urination) and intrarectal discomfort.
- Diagnostic imaging included computed tomography (CT), magnetic resonance imaging (MRI), and cine angiography.
- The AV fistula involved critical pelvic structures: bladder, prostate, and rectum.
Findings:
- Diagnosis was confirmed via advanced imaging techniques.
- Surgical intervention involved ligation of the main feeding arteries supplying the fistula.
- The patient also had benign prostatic hypertrophy, managed conservatively due to high surgical bleeding risks.
Implications:
- This case underscores the diagnostic and therapeutic complexities of rare congenital pelvic AV fistulas.
- Conservative management of comorbidities like benign prostatic hypertrophy is crucial in high-risk surgical patients.
- Successful management requires a multidisciplinary approach involving urology, radiology, and vascular surgery.
Abstract:
A congenital arteriovenous fistula (AV fistula) in the true pelvis is extremely rare, especially in males. We present a case of this disease with pollakiuria and intrarectal discomfort. Diagnosis was made by computed tomography and magnetic resonance imaging and confirmed by cine angiography. Because the AV fistula involved the bladder, prostate and rectum, ligation of the main feeding arteries was performed. He also had benign prostatic hypertrophy and was treated by conservative therapy because of a high risk of massive bleeding in surgical treatment.