Urine Leaks and Urinomas: Diagnosis and Imaging-guided Intervention
Top Cited Papers
- 1 September 2003
- journal article
- review article
- Published by Radiological Society of North America (RSNA) in RadioGraphics
- Vol. 23 (5), 1133-1147
- https://doi.org/10.1148/rg.235035029
Abstract
Urine leaks from the kidney, ureter, bladder, and urethra most commonly result from trauma. Urinomas may be occult initially and may lead to complications such as abscess formation and electrolyte imbalances if not promptly diagnosed and appropriately managed. Radiologists play a key role in diagnosing urine leaks and determining their cause and extent. Contrast material-enhanced computed tomography (CT) with delayed imaging, CT cystography, and retrograde urethrography are the diagnostic imaging studies of choice. Studies such as intravenous pyelography, antegrade and retrograde pyelography, renal scintigraphy, and imaging-guided needle aspiration may play complementary diagnostic roles. In some instances, the role of the radiologist ends with the diagnosis of urine leaks, after which patients are treated conservatively or perhaps surgically. Uncomplicated renal urine leaks, extraperitoneal urinary bladder rupture, and type 1 urethral injuries are generally managed conservatively. Urine leaks that require more extensive, imaging-guided treatment can usually be managed safely and effectively with a combination of percutaneous urinoma drainage catheters, percutaneous nephrostomy catheters, ureteral stents, and bladder drainage. In the appropriate setting, use of these management options may reduce urinoma-related complications and limit or totally eliminate the need for urologic surgery.Keywords
This publication has 12 references indexed in Scilit:
- Renal Trauma: Radiologic Evaluation and Percutaneous Treatment of Nonvascular InjuriesAmerican Journal of Roentgenology, 2002
- Treatment of posterior and anterior urethral traumaBJU International, 2002
- Urinomas caused by ureteral injuries: CT appearanceAbdominal Radiology, 2002
- Ureteral injury presenting with hyponatremiaPublished by Ovid Technologies (Wolters Kluwer Health) ,2001
- Imaging of renal traumaImaging, 2001
- The Great EscapeAmerican Journal of Roentgenology, 2000
- Ureteric InjuriesJournal Of Trauma-Injury Infection and Critical Care, 1999
- Combined Retrograde-Antegrade Ureteral Stent Passage: Salvage Procedure for a Ureteral LeakJournal of Vascular and Interventional Radiology, 1992
- Percutaneous Ureteral Occlusion with Use of Gianturco Coils and Gelatin Sponge. Part II. Clinical ExperienceJournal of Vascular and Interventional Radiology, 1992
- Transrenal Ureteral Occlusion with Gianturco Coils and Gelatin SpongeRadiology, 1989