Urinary extravasation in the newborn male with posterior urethral valves

Greenfield, Saul P.; Hensle, Terry W.; Berdon, Walter E.; Geringer, Alan M.

doi:10.1016/s0022-3468(82)80441-7

Cited by 29 publications

(11 citation statements)

References 16 publications

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“…Urinoma and urinary ascites are recognized associations of neonatal PUV but the pathogenesis is not always clear [1,2]. However, a calyceal perforation and leakage of Fig.…”

Section: Commentmentioning

confidence: 99%

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Urinoma and urinary ascites secondary to calyceal perforation in neonatal posterior urethral valves

Ahmed

Borghol

Hugosson

1997

British Journal of Urology

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A 4-day-old male presented with a large left upper abdominal mass which was diagnosed as a urinoma on ultrasonography (Fig. 1a). A micturating cystourethrogram (MCUG) showed PUV but no VUR. Percutaneous drainage of the urinoma and vesicostomy were performed. A contrast study showed a calyceal perforation (Fig. 1b) but this closed spontaneously. At 6 months, the PUV were fulgurated and the vesicostomy closed; the follow-up assessment at 2 years was satisfactory, with left renal function of 52% on 99mTc-DTPA renal nuclide scan (RNS), and normal overall renal function. Case 2A newborn male with a pre-natal diagnosis of ascites (aspirated at 32 weeks) had typical PUV on MCUG together with bilateral VUR and right calyceal perforation (Fig. 2). The ascites was aspirated and vesicostomy performed. At 8 months, the PUV were fulgurated and the vesicostomy closed. At 18 months, renal function was normal, with the right kidney contributing 41% on RNS. CommentUrinoma and urinary ascites are recognized associations of neonatal PUV but the pathogenesis is not always clear [1,2]. However, a calyceal perforation and leakage of Fig. 1. a, Longitudinal ultrasonogram showing a large anechoic mass lateral to the left kidney, which is medially displaced, compressed and hydronephrotic (arrow). The findings were consistent with a diagnosis of urinoma. b, Contrast medium injected into the 'urinoma' catheter shows the lateral anterior urinoma (arrow) and contrast filling of the left pelvicalyceal system through a calyceal perforation (hollow arrow). Intraperitoneal contrast medium is also seen below the left diaphragm.

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“…Urinoma and urinary ascites are recognized associations of neonatal PUV but the pathogenesis is not always clear [1,2]. However, a calyceal perforation and leakage of Fig.…”

Section: Commentmentioning

confidence: 99%

“…MCUG is necessary to diagnose PUV and ipsilateral VUR may further elucidate the diagnosis. Renal nuclide scanning and IVU may outline the urinoma, show renal displacement and detect a calyceal communication [2,3]. The diagnosis of urinary ascites is also based on a clinical assessment together with these investigations.…”

Section: Commentmentioning

confidence: 99%

Urinoma and urinary ascites secondary to calyceal perforation in neonatal posterior urethral valves

Ahmed

Borghol

Hugosson

1997

British Journal of Urology

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“…[14][15][16] Because urinomas associated with PUV are an uncommon occurrence, the significance of urinomas in PUV patients remains unclear. The postnatal function of kidneys with urinomas and PUV has been previously reported to be between 20% and 71%.…”

Section: Discussionmentioning

confidence: 99%

“…The postnatal function of kidneys with urinomas and PUV has been previously reported to be between 20% and 71%. [6][7][8][9][10][11][12][13][14][15][16] In 1990, Fernbach et al [1] described 5 cases with PUV, in which renal function was preserved in the presence of a urinoma. However, later studies have not identified any protective effect for urinomas in PUV patients.…”

Section: Discussionmentioning

confidence: 99%

Fetal urinoma and prenatal hydronephrosis: how is renal function affected?

Oktar

Salabaş

Kalelioğlu

et al. 2013

Turkish Journal of Urology

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Objective: In our study, the functional prognosis of kidneys with prenatal urinomas were investigated. Material and methods:Between 2006 and 2010, fetal urinomas were detected in 19 fetuses using prenatal ultrasonography (US), and the medical records were reviewed retrospectively. Of the 19 cases, the follow-up data were available for 10 fetuses. The gestational age at diagnosis, prognosis of urinomas, clinical course and renal functions were recorded. Postnatal renal functions were assessed with renal scintigraphy.Results: Unilateral urinomas and increased parenchyma echogenicity in the ipsilateral kidney were detected in all of the fetuses. Of the 10 fetuses with follow-up data, the option of termination was offered in 6 cases of anhydramnios, including 3 cases with signs of infravesical obstruction (a possible posterior urethral valve (PUV) and poor prognostic factors and 3 cases with unilateral hydronephrosis and increased echogenicity in the contralateral kidney. Only one family agreed the termination. The other 5 fetuses died during the early postnatal period. The average postnatal follow-up period in the 4 surviving fetuses was 22.5 months (8-38 months). One patient with a PUV underwent ablation surgery during the early postnatal period. In the postnatal period, none of the 4 kidneys that were ipsilateral to the urinoma were functional on scintigraphic evaluation. The urinomas disappeared in 3 cases. Nephrectomy was performed in one case due to recurrent urinary tract infections. Conclusion:In our study, no function was detected in the ipsilateral kidney of surviving patients with urinomas. Upper urinary tract dilatation accompanied by a urinoma is a poor prognostic factor for renal function.

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“…According to some authors fetal ascites is a signs of severe disease while other suggest that it has a protective effect by allowing decompression of the upper urinary apparatus [52,57].…”

Section: Discussionmentioning

confidence: 99%