Iatrogenic unilateral ureteral urinoma: A case report

Urinomas are encapsulated urine collections that result from obstruction, trauma, or iatrogenic instrumentation to the pelvicalyceal system, which may occur during gynecologic surgery. We present a case of a large space occupying urinoma resulting from iatrogenic, unilateral ureteral injury following a hysterectomy five weeks prior to presentation in an adult woman. We review management, diagnostic imaging tests, and visual characteristics of urinomas found diagnostic imaging. The emergency physician should consider ureteral injury after gynecological surgery, if there are complaints of urinary obstruction and multiple attempts of Foley catheter placement with little or no urinary output. Although, a non-contrasted CT scan can be used to diagnose the urinoma, a CT scan with delayed IV contrast may improve the overall image quality and diagnoses when suspecting a large obstructing mass such as a urinoma.