Urinoma as a complication of cervical cancer

A 38-year-old woman with cervical cancer presents with abdominal pain and a palpable mass in the right flank. Abdominal computed tomography demonstrated a retroperitoneal fluid accumulation communicating with the right ureter, with extravasation of contrast media from the ureter into the accumulated fluid, suggestive of urinoma secondary to ureter rupture (Figure 1). A urinoma results from leakage of urine from the urinary system due to trauma, iatrogenesis, infection, or rupture from pressure of the urogenital system¹, whose formation requires the maintenance of renal function². Early diagnosis through imaging exams is important to avoid complications such as hydronephrosis or abscess³.

Figure 1
Urinoma due to rupture of the right ureter, secondary to obstruction due to cervical cancer. Computed tomography with iodinated contrast media showed, in the portal phase, thickening of the uterine cervix wall with the contrast-enhancement, invading the urinary bladder trigone (arrows in A), associated with bilateral hydronephrosis and a retroperitoneal fluid collection adjacent to the right ureter (arrows in B). In the excretory phase of the computed tomography, there was extravasation of the contrast media from the right ureter into the fluid collection (arrows in C). Reconstruction in the coronal plane of the exam better demonstrated the communication between the right ureter and the fluid collection, characterizing the urinoma (arrow in D).

References

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  » https://doi.org/10.1148/radiographics.21.5.g01se131103
• ^2.
  McInerney D, Jones A, Roylance J. Urinoma. Clin Radiol. 1977;28(3):345–51. doi: http://doi.org/10.1016/S0009-9260(77)80195-5. PubMed PMID: 862327.
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  Titton RL, Gervais DA, Hahn PF, Harisinghani MG, Arellano RS, Mueller PR. Urine leaks and urinomas: diagnosis and imaging-guided intervention. Radiographics. 2003;23(5):1133–47. doi: http://doi.org/10.1148/rg.235035029. PubMed PMID: 12975505.
  » https://doi.org/10.1148/rg.235035029

Publication Dates

• Publication in this collection
  16 Sept 2024
• Date of issue
  Oct-Dec 2024

History

• Received
  14 June 2024
• Accepted
  15 July 2024