URETHRAL DISRUPTION WITH URINARY EXTRAVASATION - A DELAYED COMPLICATION OF PANCREATIC TRANSPLANTATION

PURPOSE: To describe the radiographic features and potential causes of urethral disruption in pancreas transplant recipients. MATERIALS AND METHODS: Eight episodes of urinary extravasation were depicted with re trograde urethrography in five male patients who had undergone pancrea tic transplantation. The patients' medical records were reviewed to de termine a cause of the extravasations. RESULTS: Four extravasations oc curred at the proximal (deep) bulbar urethra, three at the bulbomembra nous junction of the urethra, and one at the distal bulbar urethra. Fo ur of eight cases of extravasation were preceded by recent cystoscopy or placement of a Foley catheter; one case was preceded by possible ur ethral injury due to a fall. CONCLUSION: Urethral disruption occurs as a complication of pancreatic transplantation. It has so far been seen only in male patients and occurs at the bulbar urethra or bulbomembra nous junction. If the treating physician is unaware of this condition, diagnosis and institution of appropriate therapy may be delayed. Rece nt prior urinary tract instrumentation or trauma may be predisposing f actors in urinary extravasation.