Post-traumatic urinoma in two cats: Imaging diagnosis

https://doi.org/10.17221/179/2019-VETMEDCitation:Manzini M., Crisi P., Del Signore F., Torre V., Stehlik L., Tamburro R., Vignoli M. (2020): Post-traumatic urinoma in two cats: Imaging diagnosis. Veterinarni Medicina, 65: 280-288.
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A urinoma is a collection of urine surrounded by a fibrotic wall and, in the veterinary medicine, this condition is rarely reported. The aim of this study is to describe the clinical and therapeutic features of two cats with post traumatic urinomas, with particular attention paid to the imaging findings. In both patients, well-defined anechoic fluid collections in the retroperitoneal space were identified by ultrasound examinations and the laboratory tests suggested the urinous nature of the fluid. With excretory urography, the only relevant findings revealed were the abdominal and retroperitoneal loss of detail, whereas the combination of multiple techniques in Case 1 and the delayed study in Case 2, detected contrast leakage and fluid collections in the retroperitoneal space. Both patients fully recovered after either surgical or conservative treatments. In conclusion, different imaging modalities have been helpful to properly diagnose urinomas in cats and especially combined and/or delayed studies were of paramount importance for the final diagnosis.

References:
Addison ES, Halfacree Z, Moore AH, Demetriou J, Parsons K, Tivers M. A retrospective analysis of urethral rupture in 63 cats. J Feline Med Surg. 2014 Apr;16(4):300-7. https://doi.org/10.1177/1098612X13508194
 
Anderson RB, Aronson LR, Drobatz KJ, Atilla A. Prognostic factors for successful outcome following urethral rupture in dogs and cats. J Am Anim Hosp Assoc. 2006 Mar-Apr;42(2):136-46. https://doi.org/10.5326/0420136
 
Aumann M, Worth LT, Drobatz KJ. Uroperitoneum in cats: 26 cases (1986–1995). J Am Anim Hosp Assoc.1998 Jul-Aug;34(4):315-24. https://doi.org/10.5326/15473317-34-4-315
 
Bacon NJ, Anderson DM, Baines EA, White RaS. Post-traumatic para-ureteral urinoma (uriniferous pseudocyst) in a cat. Vet Comp Orthop Traumatol. 2002;15(2):123-6. https://doi.org/10.1055/s-0038-1632725
 
Della Rocca G, Catanzaro A, Conti MB, Bufalari A, De Monte V, Di Salvo A, Brondani JT, Luna SP. Validation of the Italian version of the UNESP-Botucatu multidimensional composite pain scale for the assessment of postoperative pain in cats. Vet Ital. 2018 Mar 31;54(1):49-61.
 
Geel JK. Perinephric extravasation of urine with pseudocyst formation in a cat. J S Afr Vet Assoc. 1986 Mar;57(1):33-4.
 
Goldwasser J, Wahdat R, Espinosa J, Lucerna A. Urinoma: Prompt diagnosis and treatment can prevent abscess formation, Hydronephrosis, and a progressive loss of renal function. Case Rep Emerg Med. 2018 Sep 25;2018:5456738. https://doi.org/10.1155/2018/5456738
 
Gorincour G, Rypens F, Tomainen-Salo S, Grignon A, Lambert R, Audibert F, Garel L, Fournet JC. Fetal urinoma: two new cases and a review of the literature. Ultrasound Obstet Gynecol. 2006 Nov;28(6):848-52. https://doi.org/10.1002/uog.2830
 
Halfacree ZJ, Tivers MS, Brockman DJ. Vaginourethroplasty as a salvage procedure for management of traumatic urethral rupture in a cat. J Feline Med Surg. 2011 Oct;13(10):768-71. https://doi.org/10.1016/j.jfms.2011.05.013
 
Lemire TD, Read WK. Macroscopic and microscopic characterization of a uriniferous perirenal pseudocyst in a domestic short hair cat. Vet Pathol. 1998 Jan;35(1):68-70. https://doi.org/10.1177/030098589803500107
 
Lopez A, Lofstedt J, Burton S. Urinoma (para-ureteral pseudocyst) in a postparturient cow. Can Vet J. 1995 Apr;36(4):242-3.
 
McGeady JB, Breyer BN. Current epidemiology of genitourinary trauma. Urol Clin North Am. 2013;40(3):323-34. https://doi.org/10.1016/j.ucl.2013.04.001
 
Meige F, Sarrau S, Autefage A. Management of traumatic urethral rupture in 11 cats using primary alignment with a urethral catheter. Vet Comp Orthop Traumatol. 2008;21(1):76-84. https://doi.org/10.1160/VCOT-07-01-0010
 
Moores AP, Bell AM, Costello M. Urinoma (para-ureteral pseudocyst) as a consequence of trauma in a cat. J Small Anim Pract. 2002;43(5):213-6. https://doi.org/10.1111/j.1748-5827.2002.tb00060.x
 
Phillips B, Holzmer S, Turco L, Mirzaie M, Mause E, Mause A, Person A, Leslie SW, Cornell DL, Wagner M, Bertellotti R. Trauma to the bladder and ureter: A review of diagnosis, management, and prognosis. Eur J Trauma Emerg Surg. 2017;43(6):763-73. https://doi.org/10.1007/s00068-017-0817-3
 
Tidwell AS, Ullman SL, Schelling SH. Urinoma (para-ureteral pseudocyst) in a dog. Vet Radiol. 1990 Jul;31(4):203-6.  https://doi.org/10.1111/j.1740-8261.1990.tb01812.x
 
Titton RL, Gervais DA, Hahn PF, Harisinghani MG, Arellano RS, Mueller PR. Urine leaks and urinomas: Diagnosis and imaging-guided intervention. Radiographics. 2003;23(5):1133-47. https://doi.org/10.1148/rg.235035029
 
Weisse C, Aronson LR, Drobatz K. Traumatic rupture of the ureter: 10 cases. J Am Anim Hosp Assoc. 2002 Mar-Apr;38(2):188-92. https://doi.org/10.5326/0380188
 
Worth AJ, Tomlin SC. Post-traumatic paraureteral urinoma in a cat. J Small Anim Pract. 2004 Aug;45(8):413-6. https://doi.org/10.1111/j.1748-5827.2004.tb00258.x
 
Yitta S, Saadai P, Filly RA. The fetal urinoma revisited. J Ultrasound Med. 2014 Jan;33(1):161-6. https://doi.org/10.7863/ultra.33.1.161
 
Zaccara A, Brizzi C, Mobili L, Nahom A, Carnevale E, Marciano A, Giorlandino C, De Gennaro M. Fetal urinoma in females without obstructive uropathy. Fetal Diagn Ther. 2011;29(4):296-300. https://doi.org/10.1159/000322387
 
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