Neonatal urinomas: Imaging considerations

Abstract

Neonatal urinomas can be defined as encapsulated extravasations of urine occurring secondary to congenital obstructive uropathies. Since 1978, four patients with proven urinomas have been studied at the Medical University of South Carolina, three of which had posterior urethral valves and the fourth, a segmental ureteral atresia. They were classified into three major types; subcapsular, diffuse perirenal and localized perirenal. The radiologic and imaging appearances are demonstrated. We found the most efficacious approach for identification of neonatal urinomas to be renal ultrasound, voiding cystourethrography and the Tc-99m DPTA renal scintigraphy.

Distal ureteral atresia – an embryological dilemma

“…Renal dysfunction in UA persists even after relief of obstruction . Only four cases so far have preserved function, which include a 5 week neonate with urinoma who underwent pyelocystoplasty, 12 a three week neonate with urinary ascites, 13 a 10 year old with cross fused ectopia 14 and a 10 month old with a temporary diversion and definitive reconstruction after nine years. 15 Loss of renal function in Case 2, in spite of timely diversion and improvement in hydroureteronephrosis, is attributable to preexisting renal dysplasia.…”

Proximal ureteral atresia, a rare congenital anomaly—incidental finding: a case report

“…Three of these, are related to adult patients (8)(9)(10). Between these 11 reports, 4 reported a successful preservation of renal function (Ashimine S, Hedden R, Morozumi M, Macpherson RI) (11)(12)(13)(14), while 2 described the association of distal ureteral atresia with ipsilateral ureteropelvic junction obstruction (Bagnara et al and Shuiqing et al). Ureteral atresia is often cause of hydronephrosis, due to the obstruction of urine from the kidney.…”

Distal ureteral atresia: Recovery of renal function after relief of obstruction at ten months old

“…Renal dysfunction associated with atresia of the distal ureter is generally thought to be irreversible after relief of the obstruction 1,2 . However, three cases of successful restoration of renal function have been reported in patients with distal ureteral atresia who underwent urinary drainage 3–5 . Macpherson et al .…”

“…Macpherson et al . reported a 5‐week‐old boy with urinoma caused by a blind‐ending renal pelvis, in whom pyeloplasty (pyelocystoplasty) led to the recovery of renal function 3 . Hedden et al .…”