Diagnosis and Management of a Challenging Patient: Ureteroarterial Fistula

While uncommon, ureteral arterial fistula (UAF) should be a differential diagnosis for persistent hematuria, as management involves coordinated treatment with a multidisciplinary team. Despite various diagnostic modalities available, accuracy in diagnosis remains a challenge. We present a patient with known UAF risk factors, including chronic ureteral stent, history of radiation, and vascular procedures. Despite multiple negative imaging studies, UAF was ultimately diagnosed and successfully managed by an endovascular approach, with resolution of her hematuria.