title: External iliac vein - transplant ureteral fistula combined with renal cell carcinoma: an unusual case of hematuria.
abstract: Iliac vein-ureteral fistula is a rare cause of hematuria. The diagnosis of an iliac vein-ureteral fistula can be elusive even with the use of multiple methods. With regards to the treatment, there appears to be a shift in management from primarily open surgical to primarily angiographic management. We present a unique case of an external iliac vein - transplant ureteral fistula. A 48 year-old female complained of recurrent gross hematuria. She underwent transplant nephrectomy and radical left nephrectomy because of rejection of transplanted kidney and cystic renal cell carcinoma when the hematuria arose for the first time. Ten months later, the hematuria recurred again, and cystoscopy showed bleeding from the right transplant ureteral orifice. Open exploration confirmed the diagnosis of external iliac vein - transplant ureteral fistula. Diagnostic difficulties and treatment dilemma of such a rare cause of hematuria are also discussed.
authors.affiliation: Department of Urology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.
authors.forename: Jin-Dan
authors.initials: JD
authors.lastname: Luo
authors.affiliation: Department of Urology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.
authors.forename: Ben
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Urology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.affiliation: Department of Urology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhou
authors.affiliation: Department of Urology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.
authors.forename: Xiang-Lai
authors.initials: XL
authors.lastname: Xu
authors.affiliation: Department of Urology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.
authors.forename: Shi-Qi
authors.initials: SQ
authors.lastname: Li
authors.affiliation: Department of Urology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.
authors.forename: Song-Liang
authors.initials: SL
authors.lastname: Cai
authors.affiliation: Department of Urology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China.
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Wang
keywords: hematuria; iliac vein; renal transplantation; ureteral fistula
references.citation: J Vasc Surg. 1996 Oct;24(4):680-6
references.pmid: 8911417
references.citation: J Obstet Gynaecol. 2012 Oct;32(7):617-20
references.pmid: 22943703
references.citation: J Urol. 1978 Dec;120(6):678-81
references.pmid: 731804
references.citation: Int Urol Nephrol. 2007;39(3):751-3
references.pmid: 17109202
references.citation: Tech Vasc Interv Radiol. 2009 Sep;12(3):216-21
references.pmid: 19945662
references.citation: Eur J Vasc Endovasc Surg. 2001 Sep;22(3):191-6
references.pmid: 11506509
references.citation: Radiat Med. 2008 Jul;26(6):372-5
references.pmid: 18677613
references.citation: J Urol. 1992 Sep;148(3):863-4
references.pmid: 1512841
references.citation: J Urol. 1997 Sep;158(3 Pt 1):754-8
references.pmid: 9258074
references.citation: Urology. 2005 Nov;66(5):990-4
references.pmid: 16286109