Postoperative Urinary Leakage Following Partial Nephrectomy for Renal Mass: Risk Factors and a Proposed Algorithm for
T Erlich1,2, Y Abu-Ghanem1,2, J Ramon1,2
11 Department of Urology, The Chaim Sheba Medical Center, Ramat Gan, Israel.
Summary
Urinary leakage after partial nephrectomy is uncommon (2.8%) and typically managed with ureteral stents. Improved surgical experience, not patient factors, correlates with decreased leakage rates over time.
Area of Science:
- Urology
- Nephrology
- Surgical Oncology
Background:
- Urinary leakage is a potential complication following partial nephrectomy.
- Understanding its incidence, risk factors, and management is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the incidence, risk factors, management, and follow-up of urinary leakage post-partial nephrectomy.
- To propose a diagnostic and evaluation algorithm for postoperative urinary leakage.
Main Methods:
- Retrospective analysis of 752 patients undergoing partial nephrectomy for renal masses (1988-2013).
- Collection of demographic, clinico-pathologic, and operative data.
- Univariate and multivariate analyses to assess associations between urinary leakage and patient variables.
Main Results:
- The incidence of urinary leakage was 2.8% (21/752 patients).
- Most cases were managed with retrograde ureteral stents (16/21), with a decreasing incidence over time (4% to 1.3%).
- Hilar renal masses and higher preoperative creatinine were associated with leakage on univariate analysis, but not multivariate.
Conclusions:
- No preoperative patient or tumor characteristics were significantly associated with increased urinary leakage risk.
- Improved surgical skills and cumulative experience appear to be the primary drivers for the observed decrease in urinary leakage rates.
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