Factors associated with urinoma accompanied by ureteral calculi

Abstract

Objective: Urinoma is a rare entity and mainly occurs due to acute obstruction such as ureteral stone. We aimed to demonstrate factors associated with urinoma accompanied by ureteral calculi. Material and methods: Data of 550 patients who were diagnosed with ureteral stone by computed tomography (CT) were analyzed retrospectively. In 20 patients perirenal urinoma was associated with ureteral calculi (group I), whereas in other 530 patients no urinoma was detected (group II). Gender, age, size, side and localization of the stone, hydronephrosis, fever, sepsis, urinary tract infections (UTIs), hematuria, serum creatinine, blood urea nitrogen (BUN), white blood cell (WBC), C-reactive protein (CRP), presence of diabetes mellitus (DM), hypertension (HT) and cronic kidney disease (CKD) of the two groups were compared. Results: The average age of the patients were 46.2 (20-71) and 44.9 (10-82) years in group I and group II, respectively (p > 0.05). According to our results leukocytosis, microscopic and macroscopic hematuria, UTIs, increase of serum creatinine, BUN and CRP, diagnosis of DM and HT were significantly associated with urinoma (p < 0.05). In addition, patients with distal ureteral stones are more prone to urinoma (p = 0.001). An interesting finding of the study was that the stone size in group I (median 5 mm [range 3-8]) was significantly smaller than in group II (9.3 mm [4-25]; p = 0.001). Conclusions: Small stone size, distal localisation of the stone in ureter, leukocytosis, hematuria, UTIs, increase of serum creatinine, BUN and CRP, presence of DM and HT are associated with perirenal urinoma.

Tranexamic acid-induced ureteric clot obstruction in a patient with urothelial cell carcinoma resulting in upper urinary tract perforation

“…UUT perforation due to clot formation is very rare 11 12. The most common cause of UUT perforation is urolithiasis (74%), especially small, distal ureteric stones 11 13. Other cause of UUT perforation include: malignant (8%) and benign (2%) extrinsic ureteric compression, iatrogenic injury (3.7%), pelvic–ureteric obstruction (2%), vesico–ureteric obstruction (1%) and bladder outflow obstruction (1%) 11.…”

A Preliminary Investigation on the “Swinging Kidney”: A Sonographic Sign Useful for Diagnosing Renal Colic

“…This discrepancy was probably due to the fluid being outside the fibroadipose capsule surrounding the kidney due to injuries to the proximal ureter caused by the passage of the stone, rather than starting inside the capsule. 15 The SK sign has the potential to play a prognostic role. The probability of spontaneously ejecting a kidney stone is related to the location and size of the stone.…”

“…Urine is first diffused in the subcapsular area, then, as the liquid accumulates, in the perirenal and retroperitoneal areas. 14,15…”

“…This discrepancy was probably due to the fluid being outside the fibroadipose capsule surrounding the kidney due to injuries to the proximal ureter caused by the passage of the stone, rather than starting inside the capsule. 15…”

“…Urine is first diffused in the subcapsular area, then, as the liquid accumulates, in the perirenal and retroperitoneal areas. 14,15 It has been speculated that during renal colic, a critical increase in endoureteral pressure might sometimes occur with laceration of the fornix and leakage of a small amount of urine, even undetectable during ultrasound examination, which can determine the typical kinetics of the "swinging kidney." The SK sign is evidence of microlaceration of the excretory system during renal colic.…”