Vascular Pseudoaneurysms in Urology: Clinical Characteristics and Management

Abstract

Vascular pseudoaneurysm is an important but rare complication that is increasingly reported after minimally invasive urologic surgery. This diagnosis necessitates a high index of suspicion and radiologic acumen. Treatment is individually tailored to each patient, but selective embolization appears to be the standard of care.

A bulbar artery pseudoaneurysm following traumatic urethral catheterization

“…4 A pseudoneurysm needs to be treated when it is symptomatic, not resolving with conservative management or enlarging. 2 We speculate that possible risks of urethral pseudoaneurysm embolization are erectile dysfunction and urethral stricture due to necrosis. The limited number of cases reported to date makes this impossible to determine.…”

“…This can be caused by a trauma, inflammation or, more commonly, iatrogenically. 2 A pseudoaneurysm can form in any blood vessel and the presentation will depend on the location and size of the lesion. Pseudoaneurysms following percutaneous nephrolithotomy, partial nephrectomy, radical nephrectomy, radical prostatectomy, radical cystectomy, and abdominal trauma have all been reported in the urological literature.…”

“…Pseudoaneurysms following percutaneous nephrolithotomy, partial nephrectomy, radical nephrectomy, radical prostatectomy, radical cystectomy, and abdominal trauma have all been reported in the urological literature. 2 A single case of a bulbar pseudoaneurysm has been reported in an adult. 3 The symptomatology of pseudoaneurysms is variable.…”

“…The natural history is thrombosis, progression or rupture. 2 When the bulbar artery is affected, the patient can present with intermittent hematuria or urethrorrhagia. Initially, it can be mistaken for bleeding related to a false passage.…”

“…The disadvantages of angiography are the potential for contrast-induced nephrotoxicity Urethral pseudoaneurysm and its invasive nature. 2 The complications are dependent on operator experience, vascular territory affected, the specific lesion addressed, and the clinical condition of the patient. 4 The procedure has been associated with sepsis, abscess formation, non-target embolization, haemorrhage and, even, mortality.…”