Delayed presentation of urinoma after radiofrequency ablation-assisted laparoscopic partial nephrectomy.

Abstract

PURPOSE:

To examine the outcomes and complications of thermal ablation-assisted laparoscopic partial nephrectomy (LPN).

PATIENTS AND METHODS:

Radiofrequency ablation (RFA)-assisted laparoscopic partial nephrectomy was employed in 16 consecutive renal masses with a mean size of 3.0 cm over 12 months. The indications were primarily adjacent bowel, hilar location, or both. After RFA, the renal mass was laparoscopically excised and examined pathologically.

RESULTS:

The mean operative treatment time was 99 minutes. The estimated blood loss was 121 mL, and no patient required a blood transfusion. Urinoma was diagnosed in three patients at an average of 13 days postoperatively and resolved with conservative management or ureteral stent placement.

CONCLUSIONS:

Radiofrequency ablation-assisted LPN provides effective hemostasis and, in the short term, cancer control. In this setting, urinoma presents as ipsilateral flank pain 1 to 2 weeks after surgery. The proposed mechanism for the delayed presentation is thermal injury to the collecting system, although an unrecognized direct collecting-system injury is possible. Conservative management, ureteral stent placement, or both led to resolution of all of the urinomas.

• Authors: Michael G Oefelein
• Journal: Journal of endourology (J Endourol) Vol. 20 Issue 1 Pg. 27-30 (Jan 2006) ISSN: 0892-7790 [Print] United States
• PMID: 16426128 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Aged
• Carcinoma, Renal Cell (pathology, surgery)
• Catheter Ablation (adverse effects, methods)
• Follow-Up Studies
• Humans
• Kidney Neoplasms (pathology, surgery)
• Laparoscopy
• Middle Aged
• Nephrectomy (adverse effects, methods)
• Postoperative Complications
• Retrospective Studies
• Time Factors
• Tomography, X-Ray Computed
• Urine
• Urologic Diseases (diagnostic imaging, etiology)