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Case Report
Retroperitoneal mass presenting as stress urinary incontinence: A rare case presentation
1 DO, Capt, MC, USAF, Department of Gynecologic Surgery & Obstetrics, Naval Medical Center Portsmouth, Virginia, USA
2 DO, LT, MC, USN, Department of Gynecologic Surgery & Obstetrics, Naval Medical Center Portsmouth, Virginia, USA
3 MD, Ret Col USAF, FACOG, URPS, Department of Gynecologic Surgery & Obstetrics, Naval Medical Center Portsmouth, Virginia, USA
Address correspondence to:
Nichole Nilsen
DO, 620 John Paul Jones Cir, Portsmouth, VA 23708,
USA
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Article ID: 100188Z08NN2024
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How to cite this article
Nilsen N, Fraiman A, Leach DA. Retroperitoneal mass presenting as stress urinary incontinence: A rare case presentation. J Case Rep Images Obstet Gynecol 2024;10(2):58–61.ABSTRACT
Introduction: The management of urologic injuries at the time of midurethral sling placement is well described but lacks specific guidance on when further anatomic investigation may be warranted. We present a rare case of an upper urinary tract problem and retroperitoneal mass causing lower urinary tract symptoms, specifically severe stress urinary incontinence.
Case Report: A 54-year-old female with stress urinary incontinence underwent attempted retropubic midurethral sling placement that was abandoned after repeated urinary tract injury at time of placement. A computed tomography (CT) urogram that was completed after repair of the injury identified a large retroperitoneal mass encasing the right kidney and ureter. Subsequent resection of this mass resulted in immediate resolution of the patient’s stress urinary incontinence.
Conclusion: Though urologic injuries at time of midurethral sling placement can be due to anatomic variation, further investigation is not often pursued. In the absence of relevant guidelines, clinically significant anatomic abnormalities may often be missed and left unaddressed. Though we present a rare case of stress urinary incontinence (SUI) that resolved after large mass resection, there are several risk factors present in this case that may inform clinicians when to pursue further evaluation and management.
Keywords: Midurethral sling trocar injury, Retroperitoneal mass, Stress urinary incontinence, Urinary tract injury
SUPPORTING INFORMATION
Acknowledgments
The authors thank BioRender software company for its use in creating images to demonstrate the subject anatomy.
Author ContributionsNichole Nilsen - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Aviv Fraiman - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Douglas A Leach - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Nichole Nilsen et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
