Dr. Nora Khaled Al Shehri is a fourth-year Urology Resident at Aseer Health Cluster / Aseer Central Hospital, Saudi Arabia. She holds an MBBS from King Khalid University and has clinical and academic interests in minimally invasive urology, endourology, renal vascular pathology, transplantation, robotic surgery, and surgical innovation. She is actively involved in clinical research, scientific writing, medical education, and professional development, with several publications and research projects to her credit. Dr. Al Shehri has participated in various urological conferences and scientific activities and is an invited speaker at NextGen Surgery 2027 in Zurich, Switzerland.

Title: Renal arteriovenous fistulas presenting as painless gross hematuria in a young adult male: A case report 

Abstract: Renal arteriovenous fistulas (AVFs) are rare vascular abnormalities that may present with gross hematuria. Diagnosis can be challenging when conventional imaging modalities fail to detect subtle or intrarenal vascular lesions. We report a case of a 31-year-old male present- ing with painless gross hematuria in whom both computed tomography (CT) and magnetic resonance imaging (MRI) were nondiagnostic. Diagnostic ureteroscopy excluded urothelial malignancy, and subsequent renal angiography revealed a high-flow AVF arising from intrarenal arterial branches. The lesion was successfully treated with superselective coil embolization, resulting in immediate resolution of gross hematuria and preservation of renal function. This case highlights the limitations of cross-sectional imaging and underscores the diagnostic and therapeutic value of angiography in patients with persistent unexplained gross hematuria.