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Kirsten Bouchelouche - One of the best experts on this subject based on the ideXlab platform.

Andre H Dias - One of the best experts on this subject based on the ideXlab platform.

Tomoaki Fujioka - One of the best experts on this subject based on the ideXlab platform.

  • neonatal abdominal wall Urinoma due to rupture of anterior urethral diverticulum
    International Journal of Urology, 2006
    Co-Authors: Wataru Obara, Ryuichiro Konda, Takashi Seo, Ken Ishikawa, Manabu Kinjo, Tomoaki Fujioka
    Abstract:

    An anterior urethral valve with diverticulum is an uncommon cause of congenital urethral obstruction and urinary extravasation compared with a posterior urethral valve. We report a neonate presenting with an abdominal wall Urinoma caused by rupture of an anterior urethral diverticulum. Urine drainage via urethral catheter was effective to resolve the abdominal Urinoma. Voiding cystourethrogram performed 6 months after an endoscopic incision of the distal margin of the diverticulum revealed a normal urethra with smooth voiding. To our knowledge, no similar case has been reported previously.

Joseph G Barone - One of the best experts on this subject based on the ideXlab platform.

  • abdominal wall Urinoma a complication of anterior urethral injury
    The Journal of Urology, 2001
    Co-Authors: Victor J Ferlise, Murali K Ankem, David B Glazier, Joseph G Barone
    Abstract:

    Abdominal wall Urinoma is a rare complication of anterior urethral injury because most patients present shortly after the traumatic event. 1 Therefore, to our knowledge this particular complication of anterior urethral injury has not been previously addressed in the literature. We discuss the management of a large abdominal wall Urinoma after anterior urethral injury. CASE REPORT T. B., an 11-year-old boy, sustained a straddle injury on playground equipment and did not initially report the injury. However, the following day massive scrotal swelling was noticed and he presented to the emergency room with complaints of severe suprapubic pain and the inability to urinate. Abdominal cellulitis extended to the umbilicus. The genitalia, including the penis and scrotum, were massively edematous. The perineal area demonstrated classic butterfly hematoma, suggesting anterior urethral injury. Retrograde urethrography confirmed anterior urethral injury and no contrast material entered the bladder. Broad-spectrum intravenous antibiotics were started. The patient underwent open suprapubic cystotomy. A large Urinoma was identified between Scarpa’s fascia and the external oblique fascial layers. Portions of this Urinoma were not adequately drained by the cystotomy incision due to the extent of urinary extravasation. To drain the whole urine collection 2 additional incisions were made in the anterior abdominal wall through Scarpa’s fascia (see figure). Two small Penrose drains were placed to facilitate drainage postoperatively. Bilateral scrotal incisions were also made to drain a large scrotal Urinoma but the perineal collection was not drained due to small size. Abdominal wall cellulitis resolved by postoperative day 2 and all drains were removed by postoperative day 3. The small perineal collection required operative drainage on postoperative day 12 due to abscess formation. The suprapubic tube remained in place for 8 weeks. Voiding cystourethrography before suprapubic tube removal revealed a normal urethra without stricture. At 6 months of followup the patient continues to void normally. DISCUSSION

M De Gennaro - One of the best experts on this subject based on the ideXlab platform.

  • fetal Urinoma in females without obstructive uropathy
    Fetal Diagnosis and Therapy, 2011
    Co-Authors: A Zaccara, C Brizzi, Luisa Mobili, A Nahom, Enza Carnevale, Armando Marciano, C Giorlandino, M De Gennaro
    Abstract:

    Objective: Prenatal diagnosis of Urinomas has long been established with underlying obstructive uropathy generally responsible for urinary extravasation. Because Urinoma formation represents a pop-off mechanism in cases of posterior urethral valves, the number of affected males greatly exceeds the number of females. Fetal Urinoma has rarely been reported without obstruction and in females it has only been described as a consequence of a complicated amniocentesis. Methods: Three cases of fetal Urinoma in female fetuses without any dilatation of the urinary tract are described. Since the fetus remained healthy, they were all conservatively managed. Results: Two Urinomas resolved after birth and 1 exhibited significant regression. In the second case, a compressed kidney was visualized with fetal MRI. Renal function was impaired in cases 1 and 3 and absent in case 2 (the kidney was no longer visualized). Conclusions: Fetal Urinomas can occur even in the absence of urinary tract obstruction and in a low-pressure system as is found in female fetuses. Fetal MRI may help both visualize the ipsilateral kidney and differentiate the mass from other conditions. In a healthy fetus, fetal Urinomas can be conservatively managed, but renal function after birth is often absent or impaired. Whether or not in utero aspiration may be beneficial for the preservation of renal function remains unclear.

  • fetal monolateral Urinoma and neonatal renal function outcome in posterior urethral valves obstruction the pop off mechanism
    La Pediatria medica e chirurgica : Medical and surgical pediatrics, 2002
    Co-Authors: M Silveri, A Zaccara, C Giorlandino, Ottavio Adorisio, A Pane, E Bilancioni, M De Gennaro
    Abstract:

    The "fetal Urinoma" is a clinical and diagnostic entity due to urinary extravasation, early diagnosed in fetal and/or neonatal period. Both Urinoma and urinary ascites, whose pathogenesis is not clear, are recognized associations of uterero-pelvic junction obstruction (UPJO) and neonatal posterior urethral valves (PUV) related with a protected fetal and neonatal renal function. Clinical and experimental studies have demonstrated that fetal urinary tract obstruction results in severe renal parenchymal injury. The so called "pop-off" valve mechanism has been advocated to justify the upper tract function preservation. Protective "pop-off" mechanisms, such as a unilateral reflux and dysplasia, urinary extravasation and congenital bladder diverticula are present in about 30% of patients with PUV. Their presence correlates with better overall long-term renal function. This mechanism has been justified as a sort of self derivation, to explain the renal function preservation in fetal and neonatal period. In the last two years we observed three cases of fetal monolateral Urinoma, prenatally detected in fetuses with diagnosis of PUV. All three cases did well for that concerning renal function despite some current opinions suggesting the necessity of a bilateral urinary extravasation in order to preserve upper urinary tract function.