Urinomas can occur after renal trauma or perforation of the collecting system during an endosurgical procedure. However, spontaneous urinomas are very rare. Here we report a case of a spontaneous perinephric urinoma following the removal of a Foley catheter in an 18-year-old girl with acute kidney injury caused by septic shock. The patient had been treated for septic shock, acute kidney injury, and acute respiratory distress syndrome, and had a Foley catheter in place for seven days. After Foley catheter removal, the patient complained of consistent voiding difficulty. An abdominal computed tomography scan showed a large amount of left perinephric fluid, and the aspirated fluid included urothelial cells, confirming the diagnosis of a urinoma. The urinoma was successfully treated by insertion of a double-J stent into the left ureter. This report discusses the available literature on urinomas, and their clinical features, diagnosis, and treatment.
Acute Kidney Injury* ; Adolescent ; Catheters* ; Diagnosis ; Female* ; Humans ; Respiratory Distress Syndrome, Adult ; Shock, Septic ; Stents ; Ureter ; Urinary Retention ; Urinoma* ; Vesico-Ureteral Reflux

Perforation of the ureter is a rare condition that causes a series of problems including retroperitoneal urinoma, urosepsis, abscess formation, infection, and subsequent renal impairment. There are causative factors that induce ureteric rupture, including malignancy, urinary calculi, idiopathic retroperitoneal fibrosis, recent iatrogenic manipulation, external trauma, degenerative kidney conditions, urography with external compression, and spontaneous causes. We report a rare case of ureteric rupture caused by urinary retention. The patient was treated with temporary percutaneous drainage and antibiotics. The present case illustrates that urinary retention can induce not only bladder rupture, but also ureteric rupture. It is thus of paramount importance to effectively manage patients with voiding problems.
Abscess ; Anti-Bacterial Agents ; Drainage ; Humans ; Kidney ; Retroperitoneal Fibrosis ; Rupture ; Ureter ; Urinary Bladder ; Urinary Calculi ; Urinary Retention ; Urinoma ; Urography

Spontaneous intraperitoneal extravasation of urine is rare. Perirenal urinoma may develop when obstruction to urinary flow creates sufficient back pressure to produce extravasation of urine. Urinary ascites most commonly indicate a disruption to the integrity of the urinary tract. We report a case of urinary ascites with urinoma resulting from an ureteropelvic junction obstruction in a neonate.
Ascites ; Humans ; Infant, Newborn ; Ureteral Obstruction ; Urinary Tract ; Urinoma

Renal biopsy is a crucial method in the diagnosis and treatment of acute renal failure of unknown origin, nephrotic syndrome, suspicious interstitial nephritis, and glomerulonephritis as a possible cause of hematuria or proteinuria. Complications occur in 2% to 8% of patients after percutaneous renal biopsy. Complications include gross hematuria, perirenal hematoma, arteriovenous fistula, aneurysm, injury of other organs, and urine leakage. Urine leakage as a complication after kidney biopsy is rare. We experienced a case of urine leakage into the intra-abdominal cavity after renal biopsy.
Acute Kidney Injury ; Aneurysm ; Arteriovenous Fistula ; Biopsy ; Glomerulonephritis ; Hematoma ; Hematuria ; Humans ; Kidney ; Nephritis, Interstitial ; Nephrotic Syndrome ; Proteinuria ; Urinoma

Spontaneous ureteral rupture is rare, and refers to leakage in the absence of prior ureteral manipulation, external trauma, previous surgery, or any destructive kidney disease. It presents a major diagnostic challenge due to the diversity at presentation. Here, we present a rare case of spontaneous ureteral rupture in a 62-year-old man with a history of fungal pyonephrosis (Candida) on maintenance hemodialysis, causing a large infected urinoma and abscess and a review the literature.
Abscess ; Humans ; Kidney Diseases ; Middle Aged ; Pyonephrosis ; Renal Dialysis ; Rupture ; Ureter ; Urinoma

Spontaneous rupture of the renal pelvis or ureteropelvic juction area with extravasation of urine into the perinephric space is an uncommon pathologic condition (1). We report a case of 72-year-old woman who suffered 2 days of left loin pain. The patient has got residual urine sensation and weak urine stream since she has gone through a radical hysterectomy 17 years before. Because of these symptoms of voiding difficulty, the patient had abdominal straining during her urination. A CT scan exhibited renal pelvis rupture with perirenal extravasation of urine due to severe hydronephrosis, that was exacerbated by hidden neurogenic bladder disease. Moreover, the patient has detrusor underactivity and high intravesical pressure at voiding trial in the urodynamic study. One month after the percutaneous nephrostomy insertion into the left renal pelvis, the patient was successfully treated. The size of renal pelvis decreased. Moreover, urinoma disappeared in follow up CT scan image.
Aged ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis ; Hysterectomy ; Kidney Pelvis ; Nephrostomy, Percutaneous ; Rivers ; Rupture ; Rupture, Spontaneous ; Sensation ; Tomography, X-Ray Computed ; Urinary Bladder, Neurogenic* ; Urination ; Urinoma* ; Urodynamics

PURPOSE: This study is designed to evaluate the usefulness of (99m)Tc-MAG3 renal scan in the diagnosis of early surgical complication of renal transplantation comparing with that of ultrasonography. METHODS: 203 renal transplantations, from January 2000 to December 2004, were studied retrospectively. (99m)Tc-MAG3 renal scan and ultrasonography were performed routinely for evaluation of allograft kidney at postoperative day 3, 7, 14 and 21 or 28 respectively. RESULTS: Thirteen early surgical complications (6.4%) from 203 recipients were developed during the first one month after transplantation. Six cases of urological complications were noticed. And six cases of hematoma and one case of lymphocele were also developed. (99m)Tc-MAG3 renal scan showed abnormality in ten cases (76.9%) of thirteen early surgical complications. (99m)Tc-MAG3 renal scan revealed all of six urologic complications (100%), and four of six hematomas (66.7%). But one lymphocele was not detected by (99m)Tc-MAG3 renal scan. Ultrasonography showed abnormal findings in eight cases of 13 early surgical complications (61.5%): one of four urine leakage (25%), two of two urinomas (100%), four of six hematomas (66.7%), and one lymphocele (100%). CONCLUSION: (99m)Tc-MAG3 renal scan is more sensitive than ultrasonography in detection of earlysurgical complications of renal transplantation. Then (99m)Tc-MAG3 renal scan is useful test for screening and follow-up of early surgical complications after renal transplantation.
Allografts ; Diagnosis ; Hematoma ; Kidney ; Kidney Transplantation ; Lymphocele ; Mass Screening ; Retrospective Studies ; Ultrasonography* ; Urinoma

Pelvic inflammatory disease can induce tubo-ovarian abscess, peritonitis, perihepatitis as sequelae. It can result in an associated hydroureteronephrosis or ureteral obstruction. We experienced a case of ureteral obstruction with urinoma in a 22-year old woman who had tubo-ovarian abscess, presented with fever, chills and left flank pain. She was treated with ureteroureterostomy and urinoma excision.
Abscess* ; Chills ; Female ; Fever ; Flank Pain ; Humans ; Pelvic Inflammatory Disease ; Peritonitis ; Ureter* ; Ureteral Obstruction* ; Urinoma* ; Young Adult

Urinary tract dilation is one of the most common side effects during pregnancy. This is primarily a physiologic phenomenon that is typically more prominent on the right side, and it is caused by hormonal changes and mechanical obstruction. Occasionally, urinary tract dilation leads to more serious urinary tract problems such as infection, obstructive renal failure and urinomas. Urinomas are also known as pararenal pseudocysts, and they generally occur as a result of urinary system disruption, but they only rarely occur with pregnancy. We report here on an unusual case of extremely large bilateral perirenal urinomas that were detected during the postpartum period. This was successfully resolved by percutaneous drainage and ureteral stents.
Drainage ; Female ; Humans ; Hydronephrosis ; Postpartum Period* ; Pregnancy ; Renal Insufficiency ; Stents ; Ureter ; Urinary Tract ; Urinoma*

PURPOSE: Endourological management of ureteropelvic junction obstruction (UPJO) has gained increased acceptance with high procedural success rates and low morbidity being reported. It has been suggested that Acucise endopyelotomy should be the procedure of choice for patients with UPJO. The purpose of this study is to determine the efficacy of the Acucise balloon for the treatment of ureteral strictures and UPJO. MATERIALS AND METHODS: Between March 2004 and June 2005, 13 consecutive patients (8 primary and 5 secondary cases of UPJO) underwent Acucise endopyelotomy at our institution. The preoperative evaluation included ultrasound and/or intravenous urogram with diuretic renography. The success of the procedure was based on objective radiologic improvement and the subjective resolution of symptoms. RESULTS: The mean follow-up was 6.77+/-3.83 months (range: 3-14). The mean operating time was 64.23+/-34.87 min and the mean hospital stay was 4.15+/-2.44 days. The objective success rate was 61.5% and the subjective success rate was 69.2%. There were no major complications such as vascular injury requiring transfusion. Yet a small urinoma developed in one patient. Of the 5 objective failures, 3 patients have since successfully undergone open pyeloplasty. CONCLUSIONS: In this small series, Acucise endopyelotomy is a safe and minimally invasive procedure that offered effective first-line treatment for UPJO, although multicenter randomized trials are needed to make a better comparison with the other techniques.
Constriction, Pathologic ; Follow-Up Studies ; Humans ; Length of Stay ; Radioisotope Renography ; Ultrasonography ; Ureter* ; Ureteral Obstruction ; Urinoma ; Urologic Surgical Procedures ; Vascular System Injuries