Spontaneous perforation of the ureter: clinical presentation and endourologic management.

BACKGROUND AND PURPOSE: 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.

PATIENTS AND

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.

CONCLUSION

Spontaneous perforation of the ureter should be suspected after renal colic. Endourologic treatment offers excellent results, even for the management of acute complications.