Subcapsular Kidney Urinoma After Percutaneous Nephrolithotomy

Area of Science:

• Urology
• Nephrology
• Surgical Complications

Background:

• Percutaneous nephrolithotomy (PCNL) is a common procedure for large kidney stones.
• This case highlights a rare complication following PCNL: subcapsular urinoma.

Observation:

• A 43-year-old male developed a 6cm subcapsular collection with fever and flank discomfort after PCNL.
• Initial conservative management with antibiotics was unsuccessful.
• Percutaneous drainage of the subcapsular collection was initiated, revealing purulent output evolving to urine.

Findings:

• The subcapsular collection was diagnosed as a subcapsular urinoma post-PCNL.
• Urine culture identified *Escherichia coli*, treated with targeted antibiotics.
• Drainage of the urinoma resolved the collection, allowing for planned retrograde intrarenal surgery (RIRS).

Implications:

• Subcapsular urinoma is an uncommon but severe complication of PCNL.
• Timely and accurate percutaneous drainage is essential for managing post-PCNL subcapsular urinomas.
• This case underscores the importance of vigilant monitoring for rare complications after PCNL.