Significant Upper Urinary Tract Hematuria as a Rare Complication of High-pressure Chronic Retention of Urine Following Decompression

A Case Report

Ishvar Naranji; Marco Bolgeri

Disclosures

J Med Case Reports. 2012;6(254) 

In This Article

Abstract and Introduction

Abstract

Introduction: Hematuria has been described following bladder drainage in 2% to 16% of high-pressure chronic urinary retention treatments by decompression and is generally self-limiting. We describe a case of significant bilateral upper urinary tract hematuria following drainage of high-pressure chronic retention. To the best of our knowledge, the only similar case reported in the literature was in 1944.

Case presentation: An 82-year-old Caucasian man was referred to our department with nocturnal enuresis and a palpable bladder. He was catheterized, produced a residual volume of 2900mL, and ended up becoming oliguric. Following investigations, he had bilateral nephrostomies. He was discharged 18 days after presentation.

Conclusions: Clinicians should keep in mind the presentation discussed in this case report to be able to swiftly manage this extremely rare complication of decompression in patients with high-pressure chronic retention.

Introduction

High-pressure chronic retention is maintenance of voiding, with a bladder volume of greater than 800mL and an intravesical pressure above 30cm H2O, accompanied by hydronephrosis.[1] The treatment involves catheterization to relieve the pressure on the kidneys and allows normalization of renal function. We anticipate hematuria in 2% to 16% of cases and a profound diuresis following drainage of the bladder.[2] We report the case of an 82-year-old Caucasian man who instead became oliguric and had significant hematuria affecting the upper renal tract.

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