Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

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16:23 - 16:26
S3-11 (CP)
ENDOSCOPIC TREATMENT WITH INJECTION OF SCLEROSING AGENT IN
PATIENTS WITH BLADDER VENOUS VASCULAR MALFORMATION
Jimena ESNAOLA1, Julia UDAQUIOLA1, Roberto VAGNI 1, Juan BORTAGARAY1, Anahi SALOMON 1, Victor ARANIBAR2, Maria
ORMAECHEA1, Francisco DE BADIOLA1 and Juan MOLDES 1
1) Hospital Italiano de Buenos Aires, Cirugia y Urologia Pediatrica, Buenos Aires, ARGENTINA - 2) Hospital Italiano de
Buenos Aires, Urologia Pediatrica, Buenos Aires, ARGENTINA
PURPOSE
Vascular malformations represent a very diverse group of pathologies with different signs, symptoms and type of
location. Security and efficiency of sclerosis with sotradecol was evaluated.
MATERIAL AND METHODS
A sixteen years old female patient with a complex venous vascular malformation in pelvis, symptomatic since 6 years
old.
An event of massive bleeding and hemartrosis took place during a knee deflection surgery. Subsequently she presented
hypersensitivity in the lower right leg with impossibility to extend the homolateral lower limb.
She had episodes of hematuria and prolonged menstrual cicles since 15 years old.
RESULTS
Patient was evaluated by the the Vascular Anomalies Clinic of Hospital Italiano.
CT and Angiography findings: Venous dilatation of the vertebral plexus with nerve compression at the fourth-fifth
lumbar vertebrae. An heterogeneous image which protruded in the bladder of 36x41x40 mm, and Multiple enlarged and
tortuous veins in the right leg.
MRI displayed a diffuse venous vascular malformation in pelvis and bladder.
In the following four months the patient underwent two episodes of hematuria with signs of hipovolemic shock, the
treatment of the vascular malformation was decided.
An Endoscopy was carried out, there were findings of Venous Vascular malformation at the upper side of the bladder
with multiple enlarged, tortuous and varicose veins and residual blood. Sclerosis with sotradecol under endoscopic and
radioscopic guidance was performed.
The procedure was well tolerated, wiht no complications. The patient no longer presented episodes of macro or micro
hematuria, with a year of follow up.
CONCLUSIONS
Endoscopy is the first choice for diagnostic in patients with vascular malformations and hematuria, in order to detect the
location and type of bleeding.
Sclerosis with endoscopic guidance has proven to be useful and safe in patients with venous vascular malformation
whom affect bladder and produces hematuria.