Giant urinoma in a newborn boy with a posterior urethral valve: A сase report and review

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Abstract

Posterior urethral valve is the most common cause of infravesical obstruction in male newborns. Spontaneous rupture of the urinary collecting system with urine extravasation is a rare complication in this group of children. We present a case of urinoma in a patient with a posterior urethral valve at 4 weeks of age with renal insufficiency. The transurethral destruction of the valve and evacuation of the urinoma contributed to the restoration of the urodynamics and recovery of renal function. Urinoma is a rare manifestation of this defect, and its significance for predicting the preservation of renal function has not been fully determined yet. Reports about the occurrence of urine extravasation in the posterior urethral valve and studying kidney function in the long-term period can clarify the significance of this spontaneous mechanism of urinary tract decompression.

About the authors

Ilya M. Kagantsov

Institute of Perinatology and Pediatrics, Almazov National Medical Research Centre; Pitirim Sorokin Syktyvkar State University

Author for correspondence.
Email: ilkagan@rambler.ru
ORCID iD: 0000-0002-3957-1615
SPIN-code: 7936-8722

Dr. Sci. (Med.), Chief Researcher

Russian Federation, 2 Akkuratova str., Saint Petersburg, 197341

Suren S. Zadykyan

Center of Protection of Motherhood and Childhood

Email: mdoctor@inbox.ru
ORCID iD: 0000-0001-5544-7713
SPIN-code: 4353-7005

Cand. Sci. (Med.)

Russian Federation, 2 Akkuratova str., Saint Petersburg, 197341

Robert S. Zadykyan

Center of Protection of Motherhood and Childhood

Email: robs90@inbox.ru
ORCID iD: 0000-0002-5994-0537
SPIN-code: 7964-7037

Pediatric Surgeon

Russian Federation, 2 Akkuratova str., Saint Petersburg, 197341

Vyacheslav G. Svarich

Pitirim Sorokin Syktyvkar State University; Republican Children’s Clinical Hospital

Email: svarich61@mail.ru
ORCID iD: 0000-0002-0126-3190
SPIN-code: 7684-9637

Dr. Sci. (Med.), Professor

Russian Federation, 2 Akkuratova str., Saint Petersburg, 197341

Vladimir G. Bairov

Institute of Perinatology and Pediatrics, Almazov National Medical Research Centre

Email: bairov_vg@almazovcentre.ru
ORCID iD: 0000-0002-8446-830X
SPIN-code: 6025-8991

Dr. Sci. (Med.), Professor

Russian Federation, 2 Akkuratova str., Saint Petersburg, 197341

Anna A. Sukhotskaya

Institute of Perinatology and Pediatrics, Almazov National Medical Research Centre

Email: sukhotskaya_aa@almazovcentre.ru
ORCID iD: 0000-0002-8734-2227
SPIN-code: 6863-7436

Cand. Sci. (Med.), Associate professor

Russian Federation, 2 Akkuratova str., Saint Petersburg, 197341

References

  1. Heikkilä J, Taskinen S, Rintala R. Urinomas associated with posterior urethral valves. J Urol. 2008;180(4):1476–1478. doi: 10.1016/j.juro.2008.06.056
  2. Wells JM, Mukerji S, Chandran H, et al. Urinomas protect renal function in posterior urethral valves a population based study. J Pediatr Surg. 2010;45(2):407–410. doi: 10.1016/j.jpedsurg.2009.10.084
  3. Bernardes LS, Salomon R, Aksnes G, et al. Ultrasound evaluation of prognosis in fetuses with posterior urethral valves. J Pediatr Surg. 2011;46(7):1412–1418. doi: 10.1016/j.jpedsurg.2010.12.010
  4. Dobrosel’sky MV, Chepurnoy GI, Sizonov VV. A rare anatomic variant of congenital urethral valve complicated by bilateral vesicoureteral reflux. State of the art. Russian Journal of Pediatric Surgery. 2014;18(5):41–44. (In Russ.)
  5. Rittenberg MH, Hulbert WC, Snyder HM 3rd, Duckett JW. Protective factors in posterior urethral valves. J Urol. 1988;140(5):993–996. doi: 10.1016/s0022-5347(17)41908-2
  6. Gurskaya AS, Menovschikova LB, Levitskaya MV, et al. The diagnosis and treatment of neonates and infants with posterior urethral valves. Andrology and Genital Surgery. 2014;15(2):44–47. (In Russ.) DOI: 17650/2070-9781-2014-2-44-47
  7. Olhova EB, Miseriya AA, Fomichev MIu, et al. Ultrasound diagnosis of complications obstruktivnyh uropathies newborn. Radiology Practice Journal. 2020;(4):20–41. (In Russ.)
  8. Adorisio O, Silveri M, Colajacomo M, et al. The impact of perinatal urinoma formation on renal function: our experience and review of the literature. J Paediatr Child Health. 2011;47(4):217–222. doi: 10.1111/j.1440-1754.2010.01927.x
  9. Patil KK, Wilcox DT, Samuel M, et al. Management of urinary extravasation in 18 boys with posterior urethral valves. J Urol. 2003;169(4):1508–1511
  10. Lundar L, Aksnes G, Morkrid L, Emblem R. Prenatal extravasation of urine seems to preserve renal function in boys with posterior urethral valves. J Pediatr Urol. 2019;15(3):241.e1–241.e7. doi: 10.1016/j.jpurol.2019.02.010
  11. Kiliś-Pstrusińska K, Pukajło-Marczyk A, Patkowski D, et al. Spontaneous rupture of kidney due to posterior urethral valve-diagnostic difficulties. Iran J Pediatr. 2013;23(3):360–362.

Supplementary files

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2. Fig. 1. Ultrasound images of the kidneys of a 27-day-old boy with posterior urethral valve and urinoma: a — the right kidney is deformed due to external compression by perirenal fluid in the projection of the lower and middle segments; b — left kidney with an expanded cavity system

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3. Fig. 2. Computed tomography: a — urinoma with a constricted right kidney; b — excretory phase, enlargement of the calyx–pelvic system, and both ureters are shown; c — axial section; d — 3D reconstruction of the urinary tract

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4. Fig. 3. Cystourethrogram, determined by vesicoureteral reflux grade V, irregularity of the bladder contour, and signs of expansion of the posterior urethra

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5. Fig. 4. Ureteroscopy of the posterior urethral valve

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6. Fig. 5. Ultrasound images of the kidneys of a child at 2.5 mon; there is a moderate dilatation of the calyx–pelvic system of both kidneys

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