Perinephric Urinoma in a Woman During the Postpartum Period: A Case Report

Khandelwal, Atul; Singh, Mahendra; Tiwari, Rajesh; Kumar, Vijoy; Khandelwal, Shivani; Ahmad, Ahsan

doi:10.3834/uij.1944-5784.2013.04.09

Cited by 1 publication

(1 citation statement)

References 13 publications

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“…CT was the modality of choice for patients who presented post-partum, used in 7/8 (88%) of studies. Three of these studies [14][15][16] used CT to confirm positive USS findings, while the remainder of studies used CT as a primary diagnostic tool. One case used CT as their primary imaging modality during the antepartum period [17].…”

Section: Imaging and Diagnosismentioning

confidence: 99%

Spontaneous renal fornix rupture in pregnancy and the post partum period: a systematic review of outcomes and management

McKnoulty

Green

Scott³

et al. 2020

BMC Urol

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Background: Spontaneous renal fornix rupture (SRFR) causing urinoma is an uncommon but serious condition in pregnancy. Limited information is available to describe the natural history and outcomes to guide appropriate treatment. The aim of this study was to determine the natural history and outcomes of SRFR to determine appropriate management recommendations. Methods: A systematic review of literature databases was performed, using the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) checklist from 1950-April 2020. Inclusion criteria included any urinary extravasation from the kidney or ureter during pregnancy, or in the 8 weeks following delivery, confirmed via imaging or surgery. Haematomas and non-confirmed cases were excluded. Results: A total of 1579 records were originally identified, of which 39 case reports were appropriate for inclusion. SRFR was most commonly reported during the first pregnancy (72%), 19/30 during the third trimester and 9 in the postnatal period. All patients presented with pain, with haematuria positive on urine dipstick in only 36% of 26 reported cases. Ultrasound was the most frequently used imaging modality, resulting in a diagnosis in 42% of cases. All cases reported on treatment procedures including ureteric stents (46%), percutaneous drain (15%), conservative management (15%), nephrostomy (13%) and ureteral catherization (10%). Long term urological outcomes were positive, however women suffering SRFR were significantly more likely to undergo pre-term labour. Conclusion: While selected cases may be successfully managed conservatively, urinary diversion, through ureteric stents, should be considered the management of choice in these individuals. Clinicians should be mindful of an increased risk of premature delivery and its' associated negative fetal outcomes.

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Section: Imaging and Diagnosismentioning

confidence: 99%