Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 11 , ISSUE 1 ( January-March, 2022 ) > List of Articles


Urine in the Pleural Space - Urinothorax Causing Massive Pleural Effusion as a Rare Complication of Percutaneous Nephrolithotomy

Divya Khanduja, Naveen Pandhi

Keywords : Double-J stenting, percutaneous nephrolithotomy, pleural effusion, thoracocentesis, urinothorax

Citation Information : Khanduja D, Pandhi N. Urine in the Pleural Space - Urinothorax Causing Massive Pleural Effusion as a Rare Complication of Percutaneous Nephrolithotomy. Indian J Respir Care 2022; 11 (1):64-66.

DOI: 10.4103/ijrc.ijrc_112_21

License: CC BY-NC-SA 4.0

Published Online: 06-12-2022

Copyright Statement:  Copyright © 2022; Indian Journal of Respiratory Care.


Urinothorax is a rare condition which is defined as collection of urine in the pleural space due to retroperitoneal leakage of urine into the pleural space. It is a rare cause of transudative pleural effusion. It is usually obstructive or traumatic in etiology. It is a rare complication associated with percutaneous nephrolithotomy (PCNL). We report the case of a 29-year-old female who presented with massive pleural effusion that developed in the patient who had undergone PCNL for renal stones. Thoracocentesis was done, and creatinine levels in pleural fluids were measured for diagnosis of urinothorax. For diagnosis, awareness of condition and high degree of clinical suspicion is required. Imaging modality such as computed tomography of the abdomen is useful for allocation of anatomical defect causing retroperitoneal leakage of urine or urinoma. We highlight the importance of early diagnosis of urinothorax for prompt treatment of the underlying condition.

  1. Corriere JN Jr., Miller WT, Murphy JJ. Hydronephrosis as a cause of pleural effusion. Radiology 1968;90:79-84.
  2. Garcia-Pachon E, Padilla-Navas I. Urinothorax: Case report and review of the literature with emphasis on biochemical diagnosis. Respiration 2004;71:533-6.
  3. Handa A, Agarwal R, Aggarwal AN. Urinothorax: An unusual cause of pleural effusion. Singapore Med J 2007;48:e289-92.
  4. Laskaridis L, Kampantais S, Toutziaris C, Chachopoulos B, Perdikis I, Tahmatzopoulos A, et al. Urinothorax-an underdiagnosed cause of acute dyspnea: Report of a bilateral and of an ipsilateral urinothorax case. Case Rep Emerg Med 2012;2012:395653.
  5. Garcia-Pachon E, Romero S. Urinothorax: A new approach. Curr Opin Pulm Med 2006;12:259-63.
  6. Leung FW, Williams AJ, Oill PA. Pleural effusion associated with urinary tract obstruction: Support for a hypothesis. Thorax 1981;36:632-3.
  7. Laforet EG, Kornitzer GD. Nephrogenic pleural effusion. J Urol 1977;117:118-9.
  8. Belis JA, Milam DF. Pleural effusion secondary to ureteral obstruction. Urology 1979;14:27-9.
  9. Bhattacharya A, Sunil VH, Santosh K, Mittal BR. Urinothorax demonstrated on 99 m TC ethylene dicysteine renal scintigraphy. Nephrol Dial Transplant. 2007;22:1782-3.
  10. Toubes ME, Lama A, Ferreiro L, Golpe A, Alvarez-Dobano JM, Gonsalez-Barcala FJ, et al. Urinothorax: A systematic review. J Thorac Dis 2017;9:1209-18.
  11. Light RW, Macgregor MI, Luchsinger PC, Ball WC Jr. Pleural effusions: The diagnostic separation of transudates and exudates. Ann Intern Med 1972;77:507-13.
  12. Chandra A, Pathak A, Kapur A, Russia N, Bhasin N. Urinothorax: A rare cause of severe respiratory distress. Indian J Crit Care Med 2014;18:320-2.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.