Bilateral urinoma

Imane Benchiba, Zineb Chaquchaq , Nissrine Mamouni , Sanaa Errarhay, Chahrazed Bouchikhi , Abdelaziz Banani

Obstetrics and Gynecology I - HASSAN II University Hospital ‚Äď Fez- Morocco

Introduction
A urinoma is a fluid mass formed by extravasated urine encapsulated in the perirenal fascia. It is also known as pseudohydronephrosis or pararenal pseudocyst.

Case report
a 26‚Äźyear‚Äźold primigravida in whom routine ultrasound examination at 26 weeks' gestation showed a male fetus¬†with isolated bilateral renal pelvic dilatation¬† No ureteral dilatation Oblique coronal fetal ultrasound showing bilateral perirenal fluid collections (arrows) compressing and displacing the kidneys. Both kidneys are hyperechoic suggesting renal dysplasia.

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Discussion
Fetal ultrasound examination enables us to diagnose and follow the progress of obstructive uropathies, including the occurrence of fetal urinomas preservation of renal function is less effective when urinomas occur¬†in utero.¬†The factors necessary for its formation had been suspected for some time, and are now well established: (1) existing renal malfunction; (2) an underlying obstruction; and (3) rupture of the collecting system.The differential diagnosis includes hydronephrosis, cystic renal disease,duplication of the intrarenal collecting system, cystic renal tumor, cystic lymphangioma, cystic neuroblastoma, mesenteric cyst and enteric duplication cyst.The prognosis was better in cases of PUV than in UPJO It and a very poor functional prognosis and the subsequent life‚Äźthreatening risk (from, for example, oligohydramnios or pulmonary hypoplasia) in cases of bilateral urinomas or urinoma in a single kidney. In‚Äźutero¬†puncture only appears to be justified in cases where the urinoma has a mass effect on adjacent major structures (especially the contralateral kidney), or in the case of probable dystocia. If a puncture is performed, a recurrence after aspiration is highly likely and repeat punctures or the initial installation of a more permanent shunt could be offered.

Conclusions
Although the precise causes of urinomas are still unknown, this review shows that in the event of a fetal urinoma, the probability of a non-functional dysplastic ipsilateral kidney lies at around 80%. In-utero puncture only appears to be justified in cases where fluid accumulation has mass effects on adjacent major structures.

References

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