Urinothorax: a new approach

Abstract

Urinothorax can be divided into two categories: (1) obstructive urinothorax, due to bilateral obstructive uropathy; and (2) traumatic urinothorax, due to unilateral traumatic injury of the urinary system, mostly iatrogenic. In patients with urinothorax, the pleural effusion usually has the biochemical characteristics of a transudate, with a pH lower than 7.30 and a pleural fluid/serum creatinine ratio higher than 1. These characteristics are not always present, however, and individually are shared by a significant number of pleural effusions of different etiology.

An unusual case of pediatric shortness of breath—answers

“…The pathology is believed to be secondary to a urinary tract obstruction leading to retroperitoneal urine moving into the pleural cavity [2]. Although the exact mechanism is unclear, retroperitoneal urine is thought enter the pleura through either congenital or iatrogenic defects in the diaphragm [3]. The diagnosis of urinothorax can be difficult, and most cases are diagnosed retrospectively.…”

“…Reported causes include bladder cancer, prostate hypertrophy, colon cancer, pancreatic cancer, trauma, renal calculi, VURD (valves, unilateral reflux, and renal dysplasia) syndrome, and non-Hodgkin lymphoma [1,3,[6][7][8][9][10]. Iatrogenic causes have also been reported, including stent removal, lithotripsy, hysterectomy, and bladder surgery [1,11,12].…”

Urinothorax in a child secondary to obstructive renal stone in a solitary functioning kidney: a case report

“…Bilateral or contralateral cases are very rare [1]. It is bilateral if there is bilateral obstructive uropathy [4]. It is due to the leakage of urine into retroperitoneal space that migrates to the pleural cavity via diaphragmatic lymphatic or through defects in diaphragm [1,3,6].…”

Flashcard: A 57-year-old woman with pleural effusion following percutaneous nephrolithotripsy

“…The effusion is usually unilateral and ipsilateral to the kidney involved. In most cases the symptoms are of mild severity [1]. The diagnosis of urinothorax is established by thoracocentesis and fluid analysis in the appropriate context.…”