What Is Urinoma

  • Jason Ha Bachelor of Medicine, Bachelor of Surgery - MBBS, University of Bristol

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Overview

A urinoma represents an accumulation of urine within the retroperitoneum, the region in the body housing the abdominal organs. Positioned behind the peritoneum, the membrane enveloping the abdominal wall and most organs like the intestines, stomach, liver, and bladder, this condition arises when urine flow is disrupted, leading to its abnormal entry into the retroperitoneum and subsequent amalgamation with fat. Typically, such occurrences arise due to obstructions, causing urine to backtrack and seep into the retroperitoneum.

The process of how the urinary system operates is as follows: upon consumption of food, the body absorbs essential energy and nutrients, while residual waste products are produced. Subsequently, the urinary system expels these liquid waste products via urine. In a properly functioning urinary system:

  • The kidneys are responsible for filtering toxins from the bloodstream and generating urine
  • Urine travels from the kidneys through slender tubes known as ureters
  • The ureters are linked to the bladder, which serves as a reservoir for urine
  • During the process of urination, urine is released from the bladder through a tube-like passage called the urethra

Symptoms

Symptoms commonly associated with urinoma include the presence of a discernible abdominal mass. Additionally, individuals might encounter:1

  • Abdominal pain
  • A general feeling of discomfort or unwellness without a clear origin (malaise)
  • Unexplained weight loss

Urinomas typically arise due to a condition leading to a urinary blockage, which can be attributed to various factors such as:

  • Bladder cancer
  • Bladder stones (bladder calculi)
  • Retroperitoneal fibrosis
  • Retroperitoneal tumors
  • Traumatic injuries affecting the abdomen or pelvis
  • Obstructions at the ureteropelvic junction
  • Furthermore, urinomas can manifest post-surgical interventions involving abdominal organs or the urinary system.

Diagnosis

The diagnostic process for urinoma involves a series of tests conducted by healthcare providers, which may include:

  • CT scans employ X-rays and computer technology to generate detailed images of the internal body structures.
  • Fluoroscopy utilises continuous X-rays to create a dynamic X-ray visualization for observing internal processes in the body.
  • MRIs utilise a combination of magnetic fields and radio waves to produce comprehensive, high-resolution images of organs and soft tissues.
  • Ultrasounds utilizing high-frequency sound waves to create real-time imagery of internal body structures.

Management and treatment

Although it is not possible to entirely prevent a urinoma, you can minimize the risk of urinary obstructions by adopting healthy bladder habits. These may include:

  • Ensuring an adequate intake of water
  • Completely emptying your bladder when urinating
  • Regular physical exercise
  • Moderating the consumption of alcohol and caffeine
  • Engaging in Kegel exercises (pelvic floor exercises)
  • Quitting smoking
  • Avoiding the habit of 'holding it' and promptly using the bathroom to minimize the risk of urinary tract infections

Numerous urinomas are small in size and typically have minimal impact on daily activities. However, larger urinomas commonly stem from an underlying issue leading to urinary blockages. Following treatment for the root cause, many individuals do not encounter additional complications related to urinomas.

Summary

Urinoma is the accumulation of urine in the retroperitoneum due to disrupted urine flow, leading to its abnormal entry into the abdominal region. Symptoms include an abdominal mass, pain, malaise, and unexplained weight loss. It is commonly caused by urinary blockages due to conditions such as bladder cancer, stones, fibrosis, tumours, or traumatic injuries. Post-surgical interventions can also lead to urinomas. Diagnostic procedures include CT scans, fluoroscopy, MRIs, and ultrasounds.

Prevention of urinomas involves maintaining healthy bladder habits like staying hydrated, emptying the bladder fully, regular exercise, moderating alcohol and caffeine consumption, pelvic floor exercises, quitting smoking, and avoiding holding urine. Small urinomas generally have minimal impact, while larger ones are usually linked to underlying issues causing urinary blockages. Treating the root cause often resolves urinoma-related complications.

References

  1. McInerney, D et al. “Urinoma.” Clinical radiology vol. 28,3 (1977): 345-51. doi:10.1016/s0009-9260(77)80195-5. Available at: https://pubmed.ncbi.nlm.nih.gov/862327/

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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