Case of pseudo-renal failure with delayed bladder injury after total laparoscopic hysterectomy

Abstract

Pseudo-renal failure is a rare condition with laboratory abnormalities mimicking acute kidney injury despite normal kidney function. When upper or lower urinary tract injury causes intraperitoneal urine leakage, reverse intraperitoneal urine dialysis leads to elevated levels of blood urea nitrogen and creatinine, hyperkalemia, and metabolic acidosis. We report a case of pseudo-renal failure with delayed bladder injury after total laparoscopic hysterectomy (TLH). A 52-year-old woman visited our hospital for treatment of multiple uterine myoma, for whom TLH was performed. After surgery, she had no urination desire and was made to urinate using urethral catheters as appropriate. After 3 days of surgery, laboratory findings showed elevated serum creatinine level. A urethral catheter was indwelled, the creatinine level improved. However, the creatinine level increased again after removal of the urethral catheter. Abdominal computed tomography (CT) showed presence of several ascites and cystoscopy showed a perforated bladder. After 6 days, bladder repair surgery was performed.