URINOMA: A POTENTIAL UROLOGIC EMERGENCY

Authors

  • Adelina MIRON “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • D. PUIU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • C. PRICOP Grigore T. Popa” University of Medicine and Pharmacy Iasi

Keywords:

URINOMA, LITHIASIS, DOUBLE-J STENT

Abstract

Aim: A urinoma is characterized as a collection of urine outside the urinary tract as a result of disruption of the collecting system induced by a high pressure in the collecting system Material and methods: We reviewed the medical records of all patients with urinoma treated in the Iasi Urology Clinic between January 1, 2013 and March 1, 2017 Results:  A total of 36 patients, (18 males and 18 females), age between 18-70 years with an average age of 51.10 years, were included. The etiology of obstruction was represented by lithiasis 29 (80.55%) cases, pelvic cancers 5 (13.88%) cases, pyelonephritis 1 (2.78%) case and trauma 1 (2.78%) case. The size of lumbar collection was between 1 cm (n=19) and 28 cm (n=1). The interval from symptom onset to presentation was: 6-10 hours - 12 (33.33%) cases; 12-24 hours - 17 (47.22%) cases, up to 5 days - 7 (19.44%) cases. The treatment was represented by the insertion of a double J stent in 29 patients, percutaneous nephrostomy in 5 (13.88%) patients. Two (5.5%) patients were treated conservatively. The post-operative evolution of patients was favorable. The ultrasound examination before discharge revealed no collection in 34 (94.44%) patients and the presence of urinoma in evident remission in 2 (5.56%) cases. Eight (22.22%) of our patients had positive urine culture with E. coli (n=4), Enterococcus spp. (n=2), Klebsiella spp. (n=1) and Pseudomonas (n=1). Six (16.66%) of our patients had infected urinoma which needed drainage of lumbar collection. Conclusions: Urinoma is a rare complication secondary to ureteral obstruction and it has a high risk of infection. All the cases must be investigated in hospital, double-J stent insertion and antibiotic therapy is the most frequent treatment option but some selected cases can be treated conservatively.

Author Biographies

  • Adelina MIRON, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Surgery (II)
    “Dr. C. I. Parhon” Clinical Emergency Hospital Iasi
    Department of Urology

  • D. PUIU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Surgery (II)
    “Dr. C. I. Parhon” Clinical Emergency Hospital Iasi
    Department of Urology

  • C. PRICOP, Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
     Department of Surgery (II)
    “Dr. C. I. Parhon” Clinical Emergency Hospital Iasi
    Department of Urology

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Additional Files

Published

2017-09-30

Issue

Vol. 121 No. 3 (2017): The Medical-Surgical Journal

Section

SURGERY

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