title: Management of iatrogenic urinothorax following ultrasound guided percutaneous nephrostomy.
abstract: A 64 year-old male with metastatic prostate adenocarcinoma presented with bilateral hydronephrosis and renal impairment. Bilateral percutaneous nephrostomy drainage followed by ante-grade stenting was done. Shortly afterwards, the patient developed an extensive left-sided pleural effusion. His serum creatinine rose and he became anuric. Emergency pleural aspiration and later, pleural drainage were performed. Pleural aspirate was diagnostic of urinothorax and non contrast CT scan demonstrated a left reno-pleural fistula. The right stent was removed cystoscopically. The left stent could not be removed cystoscopically and was replaced in an ante grade manner through a fresh percutaneous renal approach. This led to cessation of pleural fluid accumulation. The patient was discharged with bilateral ureteric stents and normal renal function. A month later, he had normal renal function, no hydronephrosis and normal chest x-rays.
authors: Department of Urology, Northwick Park Hospital, London, UK.
authors: Deepak
authors: D
authors: Batura
authors: Department of Urology, Northwick Park Hospital, London, UK.
authors: Patricia
authors: P
authors: Haylock-Vize
authors: Department of Interventional Radiology, Northwick Park Hospital, London, UK.
authors: Yaser
authors: Y
authors: Naji
authors: Department of Respiratory Medicine, Northwick Park Hospital, London, UK.
authors: Rachel
authors: R
authors: Tennant
authors: Department of Respiratory Medicine, Northwick Park Hospital, London, UK.
authors: Katherine
authors: K
authors: Fawcett
mesh_terms: D004322:Drainage / Q000009:adverse effects*; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery*; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D051437:Renal Insufficiency / Q000601:surgery*; D015607:Stents; D016896:Treatment Outcome; D053584:Urinoma / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery
keywords: Urinothorax; complication; percutaneous nephrostomy; prostate cancer; reno-pleural fistula; ureteral stent