Rectus Urinoma Leading to Abscess Following Urethral Perforation From Self-Catheterization: A Case Report

Urinomas are an accumulation of urine in the perirenal or paraureteral space due to urinary tract leakage. Stimulation of an inflammatory response results in the formation of a thick wall that encapsulates the urine. Etiologies of urinomas include trauma, surgery, or spontaneous occurrence. Complications when untreated vary and include peritonitis, fibrosis, abscess formation, and septic shock. We present a 52-year-old male with a neurogenic bladder who developed a rectus urinoma from the thorax to the scrotum. This likely developed from urethral trauma from intermittent self-catheterization. The patient received antibiotic therapy and percutaneous drainage catheters were placed in the rectus and pelvis, resolving the urinoma. We conclude that patients who perform intermittent self-catheterization may be more susceptible to formation of urinomas due to improper catheter usage. The intricate fascial connections between the pelvis and abdomen make proper interventions for suspected urinary tract injury crucial in patients who self-catheterize.