Spontaneous perforation of the ureter: clinical presentation and endourologic management
Konstantinos Stravodimos1, Ioannis Adamakis, Georgios Koutalellis
1First Department of Urology, Laiko General Hospital, University of Athens, School of Medicine, Athens, Greece. kgstravod@yahoo.com
Background And Purpose:
Spontaneous perforation of the upper ureter is a rare condition that poses diagnostic and therapeutic problems. We report on five cases from three institutions and discuss the literature.
Patients And Methods:
Five patients presented with renal colic and the imaging modalities used to assess them showed extravasation of urine.
Results:
The cause of spontaneous perforation of the ureter was a ureteral stone in one case and was unknown in four cases. In all cases, a Double-J ureteral stent was inserted under fluoroscopy. Urinoma was percutaneously drained in only one patient. Repeat imaging showed normal renal function and morphology in all patients.
Conclusion:
Spontaneous perforation of the ureter should be suspected after renal colic. Endourologic treatment offers excellent results, even for the management of acute complications.
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