Congenital pelvic arteriovenous malformation in male patients: a rare cause of urological symptoms and role of embolization

Abstract

Objectives: Congenital pelvic arteriovenous malformations (pAVM) are rare in male patients. The purpose of our study was to obtain information about the presenting symptoms, differential diagnosis, radiological diagnosis and therapy.

Patients and methods: The record of two men with congenital pAVM were reviewed to evaluate the initial symptomatology, diagnostic examinations and findings, therapeutic procedures and clinical outcome. Furthermore, our data are compared to the findings of all men reported in the literature.

Results: Including the two cases reported by us, the data on 17 men with congenital pAVM could be analyzed. Most men presented with unspecific symptoms like pelvic discomfort, pain, impotence or dysuria. The radiological diagnosis was established by magnetic resonance imaging (MRI) or by computed tomography (CT) and was confirmed by angiography in all cases. Therapy consisted of surgical excision in nine cases, embolization in four cases, embolization and surgery in three cases and medical supervision in one case.

Conclusion: Pelvic arteriovenous malformations in male patients are rare. Because of the lack of specific symptoms, they are difficult to diagnose. CT or MRI and arteriography make the diagnosis. Intra-arterial embolization can be considered as the first line treatment.