Risk Factors and Management of Urine Leaks After Partial Nephrectomy
- 31 December 2008
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 180 (6), 2375-2378
- https://doi.org/10.1016/j.juro.2008.08.018
Abstract
Purpose: As nephron sparing surgery is used more frequently for select renal tumors, the incidence of urine leaks will likely increase. To our knowledge the risk factors of and management strategies for urine leaks have not been studied. We report our experience with the risk factors of and management for urine leaks after open and laparoscopic partial nephrectomy. Materials and Methods: We retrospectively reviewed the records of 127 consecutive patients who underwent partial nephrectomy between 2001 and 2007, including 70 with open and 57 with laparoscopic partial nephrectomy, as performed by 3 surgeons. Urine leak was defined as drain output consistent with urine greater than 48 hours after laparoscopic partial nephrectomy. Results: Of the patients 21 experienced a urine leak after partial nephrectomy, including 13.3% overall, and 10.5% after laparoscopic and 18.5% after open partial nephrectomy. Patients with a urine leak had significantly greater tumor size (3.2 vs 2.4 cm, p <0.044), endophytic locations (57% vs 19%, p <0.00027) and repair of collecting system defects during partial nephrectomy (95% vs 56%, p <0.00072). There was no association with the number of tumors removed, estimated blood loss, ischemia time, body mass index, age or other surgical complications. The median duration of urine leak was 20 days. While most urine leaks resolved with prolonged drainage, 38% of cases required further intervention. Patient age at surgery was the only factor that correlated with prolonged (greater than 30 days) urine leak. Conclusions: Urine leak is a complication unique to partial nephrectomy that is more commonly noted when a larger endophytic mass involves the renal collecting system. Most leaks resolve with prolonged drainage or replacement of a ureteral stent.Keywords
This publication has 16 references indexed in Scilit:
- Laparoscopic Partial Nephrectomy for Hilar Tumors: Evaluation of Short-Term Oncologic OutcomeUrology, 2008
- Update on partial nephrectomy and novel techniquesUrologic Oncology, 2007
- Decreased Complications of Contemporary Laparoscopic Partial Nephrectomy: Use of a Standardized Reporting SystemJournal of Urology, 2007
- Laparoscopic Nephron-Sparing SurgeryJournal of Endourology, 2007
- Impact of Collecting-System Repair during Laparoscopic Partial NephrectomyJournal of Endourology, 2007
- Complications of 2,775 Urological Laparoscopic Procedures: 1993 to 2005Journal of Urology, 2007
- Laparoscopic partial nephrectomy for incidental stage pT2 or worse tumorsUrology, 2006
- Laparoscopic partial nephrectomy for renal masses: Effect of tumor locationUrology, 2006
- Open partial nephrectomy: an essential contemporary operationNature Reviews Endocrinology, 2006
- Complications of Nephron Sparing Surgery for Renal TumorsJournal of Urology, 1994