Tomaszewski et al reported risk factors for urine leak after a partial nephrectomy performed for a renal tumor. These risk factors can help to identify a patient who may benefit from modified surgery or closer monitoring. The authors are fro Fox Chase Cancer Center and Temple University in Philadelphia.


Patient selection: status post partial nephrectomy for urine leak


renal pelvic score = RPS =

= percentage of renal pelvis contained within renal parenchyma)


based on a line connecting the two polar lines on excretory phase images (see Figure 1).


If the renal pelvic score is > 50% then it is designated intraparenchymal, else extraparenchymal.


Risk factors for urine leak:

(1) intraparenchymal pelvis (OR 47.3)

(2) RENAL nephrotomy group (OR 3.2 per group: 4-6 vs 7-9 vs 10-12)

(3) surgical entry into collecting system (OR 23.9)


The risk of urine leak increases with type and number of risk factors present.

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