title: Spontaneous perforation of the ureter: clinical presentation and endourologic management.
abstract: OBJECTIVE
  Spontaneous perforation of the upper ureter is a rare condition that poses diagnostic and therapeutic problems. We report on five cases from three institutions and discuss the literature.
  
  
  METHODS
  Five patients presented with renal colic and the imaging modalities used to assess them showed extravasation of urine.
  
  
  RESULTS
  The cause of spontaneous perforation of the ureter was a ureteral stone in one case and was unknown in four cases. In all cases, a Double-J ureteral stent was inserted under fluoroscopy. Urinoma was percutaneously drained in only one patient. Repeat imaging showed normal renal function and morphology in all patients.
  
  
  CONCLUSIONS
  Spontaneous perforation of the ureter should be suspected after renal colic. Endourologic treatment offers excellent results, even for the management of acute complications.
authors.affiliation: First Department of Urology, Laiko General Hospital, University of Athens, School of Medicine, Athens, Greece. kgstravod@yahoo.com
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Stravodimos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Adamakis
authors.forename: Georgios
authors.initials: G
authors.lastname: Koutalellis
authors.forename: Georgios
authors.initials: G
authors.lastname: Koritsiadis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Grigoriou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Screpetis
authors.forename: Constantinos
authors.initials: C
authors.lastname: Constantinides
authors.forename: Anastasios
authors.initials: A
authors.lastname: Zervas
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging / Q000628:therapy; D015607:Stents; D014515:Ureteral Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D014572:Urology / Q000379:methods