In the vast majority of cases drainage of the urinoma
is sufficient to allow healing of the collecting system defect.
Distribution of Patients According to Post Operative Complications Group 1 Group 2 (URS) (Open Ureterolithotomy Gross 0 1 Hematuria Uretic 0 1 colic Residual 0 -- stone fragments Urinoma
0 0 Post-op 0 0 Urine Leak Wound 1 -- infection Note: Table made from bar graph.
Intraperitoneal bladder perforation after TURBT is a dreaded complication that may lead to various sequels such as hemorrhage, peritonitis, urinoma
, infection tumor spillage, TUR syndrome and even death.
Perinephric fluid collections include hematoma, seroma, lymphocele, urinoma
, and abscesses.
These include unilateral VUR with renal dysplasia, and the presence of urachus, ascites, urinoma
and bladder diverticula.
The urinary system obstruction is followed by an increase of intraluminal pressure, which can cause rupture of the urinary tract, urinary extravasation and development of urinoma
. A urinoma
is a localized collection of urine in the retroperitoneum, outside of the urinary tract that occurs after an injury of the urinary system wall .
If there is a ureteral defect, the patient may note profuse wound leakage, increased abdominal fluid, or a urinoma
, ileus, fever, peritonitis, or hematuria.
Bilateral perirenal urinoma
with mediastinal extension.
While, in the ED, urology was consulted and requested interventional radiology to drain the urinoma
and to place a Foley catheter to monitor urine output, the attending physician, at the request of interventional radiology, performed a needle aspiration of the loculated fluid collection in the right flank via ultrasound and noted a small amount of purulent and urine-like fluid from two separate areas of collection.
The etiology was believed to be an infected urinoma
caused by instrumentation during stent placement and she was treated with ceftriaxone and metronidazole.
A Foley catheter remained in the bladder and a drainage tube in the abdomen to prevent possible urinoma
formation and to control bleeding.
This constellation is an important clue to suspect a urinoma
, i.e., extravasation of urine.