Peritoneo-Vaginal Leaks in Peritoneal Dialysis: A Report of 3 Cases

Abstract

Introduction: Peritoneal dialysis (PD) is an extra-renal purification technique indicated for patients with end-stage kidney disease (ESKD). Although it has many advantages, it also has a number of complications, such as peritoneo-vaginal leakage of dialysate. Cases Reports: Three male patients, aged 70, 50 and 77 respectively, with ESKD were placed on PD. All three patients presented with inadequate drainage and the progressive appearance of bilateral hydrocele, which occurred one year (late leakage), two and four days (early leakage) respectively after the initiation of exchanges. The etiological investigation led to the conclusion of a peritoneo-vaginal leak associated with an inguinal hernia in only one case. The two cases of early leakage were treated by temporary suspension of PD, with a good response in one case and failure in the second, leading to hisdefinitive transfer to hemodialysis (HD); however, the hernia repair enabled immediate resumption of PD in the third patient. Discussion and Conclusion: Peritoneo-vaginal leakage is a rare mechanical complication in PD. The clinical examination plays an essential role in confirming the diagnosis and in the therapeutic decision. If the diagnosis is uncertain, or if there is a clinical need to show the anatomy of the leak, an imaging approach becomes desirable. This complication should not prevent the progression of PD in the management of patients with ESKD.