Perinephric urinoma secondary to neurogenic bladder with vesicoureteral reflux: Report of an adult case

Abstract

We report a case of infectious perinephric urinoma in a 73-year-old woman who had a neurogenic bladder with vesico-ureteral reflux. The patient was admitted to our emergency room with right lumbago and high fever. Ultrasounds and computed tomography demonstrated a right large perinephric cystic mass, bilateral hydronephrosis and much residual urine. Percutaneous drainage of the cystic mass was performed with an indwelling urethral catheter. The content of the mass was urine infected with Escherichia coli. Antibiotic therapy was performed successfully and we then examined the cause of the urinoma. A urodynamic study demonstrated a low-compliance small bladder and detrusor-sphincter dyssynergia. A voiding cystourethrogram revealed right grade III vesicoureteral reflux. The patient was unable to be cleared with intermittent catheterization and had an indwelling urethral catheter inserted. In 1 year, the voiding cystourethrogram showed no vesicoureteral reflux and the patient was well with no evidence of recurrent urinoma without the urethral catheter. There have been only two reported cases of urinoma caused by neurogenic bladder with vesico-ureteral reflux in children and this is the first case reported in an adult.

Spontaneous urinoma diagnosed before radical cystectomy: A case report

“…The most common causes of spontaneous urinoma are urinary stones [6], while bladder tumors are rare [1,2,7]. Other causes are congenital anomalies, tumors of the abdomen and pelvis, retroperitoneal fibrosis, iatrogenic and post radiation strictures and connective tissue disorders [5]. Few cases of forniceal rupture in pregnancy were described in the literature [8].…”

“…Extravasation of urine can be asymptomatic, but the most common symptoms are abdominal pain, vomiting, fever, oliguria and ileus. The treatment is individual; in some cases, endoscopic insertion of ureteral Double-J stent, or percutaneous nephrostomy are sufficient [4], while some cases require surgical treatment [5].…”

A Unique Case of Spontaneous Bilateral Renal Subcapsular Urinoma Secondary to High Pressure Chronic Retention of Urine

“…Subcapsular urinomas have been reported in the past as a presenting feature of ureteric or bladder outlet obstruction,1, 2 generally in children,3, 4 and often associated with neurogenic bladders 5 . Other instances of unilateral perinephric (extra-capsular) collections secondary to high pressure urinary retention have been described following routine laparoscopic surgery for umbilical hernia, locally advanced cervical cancer causing unilateral distal ureteric obstruction, and during intravenous urography of an obstructed ureter.…”

A case of non-Hodgkin’s lymphoma presenting as a perirenal urinoma

“…The possible causes of obstruction include ureteric calculi, periureteric masses, tumour of the ureter or bladder, benign prostatic enlargement and neurogenic bladder with vesicoureteral reflux. (1,2,3,4). Metastases from gastrointestinal malignancies to the kidney can cause calyceal rupture and urinoma (1).…”