Damage to the ureters during surgery or a procedure can result in leakage of urine, which can result in a urinoma.
Situations:
(1) pelvic exenteration for cancer, especially when there is creation of an ileal or colonic conduit
(2) intraluminal removal of ureteral stone or mass
(3) surgery on the kidney or urinary bladder
(4) gynecologic surgery
(5) other intra-abdominal or pelvic surgery
Risk factors associated with urine leak from a conduit:
(1) extensive surgery (involving all 4 pelvic quadrants)
(2) resection margin positive for tumor
(3) cardiovascular disease and/or ischemia to tissue
(4) use of a conduit catheter for conduit drainage
Many leaks occur at an anastomosis involving the ureter.
Complications:
(1) pain
(2) urinoma: a collection of urine in the retroperitoneum or pelvis.
(3) infection
(4) fistula
Fluid from the urinoma will have a very high creatinine concentration.
Many leaks can be treated by a ureteral stent with or without urinary diversion. Some cases may require a surgical revision.
