Reflex anuria: a rare postoperative complication

What is it about?

We highlight the case of a woman who had elective gynaecological surgery with bilateral prophylactic ureteric catheterisation, indicated for the excision of a mucinous cystadenoma arising from the right ovary. Surgery was successful with no intraoperative complications. Anuria and subsequent acute kidney injury developed within twelve hours of surgery. CT-KUB revealed mild bilateral hydronephrosis and perinephric stranding surrounding the left kidney with no discernible injury to the lower urinary tract. Management involved aggressive renal support, rigid cystoscopy and bilateral ureteric stenting. Diuresis and a prompt improvement in renal function ensued with no further complications. She was discharged a week after her initial operation, with a six week review for stent removal. We believe this to be a rare instance of reflex anuria due to ureteric spasm and encourage consideration of ureteric stenting as part of subsequent management.

Featured Image

Photo by Robina Weermeijer on Unsplash

Photo by Robina Weermeijer on Unsplash

Why is it important?

Reflex anuria is a debated condition that is often diagnosed as a diagnosis of exclusion in certain cases of acute kidney injury. We hope to add further information about a proposed case of reflex anuria to increase clinician awareness, provide further discussion about possible mechanisms of injury and also add to the existing literature on how patient s have been managed previously.