title: Severe hematuria after transurethral electrocoagulation in a patient with an arteriovesical fistula.
abstract: BACKGROUND
  Arteriovesical fistulas are extremely rare. Only eleven cases were previously reported in the literature. They can occur iatrogenically, traumatically or spontaneously.
  
  
  METHODS
  We report an unusual case of a 62-year-old woman with arteriovesical fistula that developed fatal hematuria after transurethral electrocoagulation. Computed tomography (CT) and selective angiography revealed a pseudoaneurysm of the right superior vesical artery with arteriovesical fistula formation, which was managed by transarterial embolization.
  
  
  CONCLUSIONS
  Contrast enhanced CT or CT angiography should be performed when a pulsatile hemorrhage is revealed during cystoscopy. Therapeutic vesical arterial embolization should be considered as a safe and effective procedure for arteriovesical fistulas. Transurethral electrocoagulation may cause severe hematuria for pulsatile bladder bleeding in patients with pelvic vascular malformation.
authors.forename: Xiangyi
authors.initials: X
authors.lastname: Zheng
authors.forename: Yiwei
authors.initials: Y
authors.lastname: Lin
authors.forename: Bin
authors.initials: B
authors.lastname: Chen
authors.forename: Xianyong
authors.initials: X
authors.lastname: Zhou
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, 79# Qingchun Road, Hangzhou 310003, Zhejiang Province, China. helaine@126.com.
authors.forename: Yuehong
authors.initials: Y
authors.lastname: Shen
authors.forename: Liping
authors.initials: L
authors.lastname: Xie
mesh_terms: D000368:Aged; D001159:Arterio-Arterial Fistula / Q000150:complications / Q000628:therapy*; D004564:Electrocoagulation / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006417:Hematuria / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D014521:Urethra; D001747:Urinary Bladder Fistula / Q000150:complications / Q000628:therapy*