Fetal urinoma and prenatal hydronephrosis: how is renal function affected?
OBJECTIVE
In our study, the functional prognosis of kidneys with prenatal urinomas were investigated.


METHODS
Between 2006 and 2010, fetal urinomas were detected in 19 fetuses using prenatal ultrasonography (US), and the medical records were reviewed retrospectively. Of the 19 cases, the follow-up data were available for 10 fetuses. The gestational age at diagnosis, prognosis of urinomas, clinical course and renal functions were recorded. Postnatal renal functions were assessed with renal scintigraphy.


RESULTS
Unilateral urinomas and increased parenchyma echogenicity in the ipsilateral kidney were detected in all of the fetuses. Of the 10 fetuses with follow-up data, the option of termination was offered in 6 cases of anhydramnios, including 3 cases with signs of infravesical obstruction (a possible posterior urethral valve (PUV) and poor prognostic factors and 3 cases with unilateral hydronephrosis and increased echogenicity in the contralateral kidney. Only one family agreed the termination. The other 5 fetuses died during the early postnatal period. The average postnatal follow-up period in the 4 surviving fetuses was 22.5 months (8-38 months). One patient with a PUV underwent ablation surgery during the early postnatal period. In the postnatal period, none of the 4 kidneys that were ipsilateral to the urinoma were functional on scintigraphic evaluation. The urinomas disappeared in 3 cases. Nephrectomy was performed in one case due to recurrent urinary tract infections.


CONCLUSIONS
In our study, no function was detected in the ipsilateral kidney of surviving patients with urinomas. Upper urinary tract dilatation accompanied by a urinoma is a poor prognostic factor for renal function.
Department of Urology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Tayfun
T
Oktar
Department of Urology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Emre
E
Salabaş
Department of Gynecology and Obstetrics, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
İbrahim
İ
Kalelioğlu
Department of Urology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Arda
A
Atar
Department of Urology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Haluk
H
Ander
Department of Urology, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Orhan
O
Ziylan
Department of Gynecology and Obstetrics, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Recep
R
Has
Department of Gynecology and Obstetrics, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Atıl
A
Yüksel
Fetal urinoma; prenatal hydronephrosis; renal function