Urinary ascites following total abdominal hysterectomy

Intraperitoneal urinary bladder perforation should be in differential diagnosis of acute renal failure soon after gynecological surgery. We present a case of massive urinary ascites and acute renal failure in a patient who presented 1 week after a total abdominal hysterectomy for simple endometrial hyperplasia. Biochemical features of uremia occur as a result of intraperitoneal extravasation of urine from urinary bladder and reabsorbtion through the peritoneum. Since those were the doctors who first diagnosed the patient, nephrologists performed dialysis therapy. After that long interval urinary catheterization of the patient had been applied. Without surgical repair and with long interval uretral catheterization primary dramatic resolution was seen as we expected. Nephrologists and gynecologists should be aware of this condition since pseudorenal failure which may resolve without dialysis might be seen due to intraperitoneal uinary bladder rupture following gynecological operations.