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Reminder of important clinical lesson
CASE REPORT
Renal failure caused by severe pelvic organ prolapse
  1. Eliane A Lucassen1,2,
  2. Claire F la Chapelle3,
  3. Esmee Krouwel4 and
  4. Marc Groeneveld2
  1. 1 Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
  2. 2 Department of Internal Medicine, Haaglanden Medical Center, The Hague, The Netherlands
  3. 3 Department Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands
  4. 4 Department of Urology, Haaglanden Medical Center, The Hague, The Netherlands
  1. Correspondence to Dr Eliane A Lucassen, e.a.lucassen{at}lumc.nl

Abstract

Pelvic organ prolapse (POP), the transvaginal descent of pelvic organs, can cause mild hydronephrosis but rarely leads to a deterioration in kidney function. We present a case of severe uterovaginal prolapse that caused bilateral ureteral obstruction and led to renal failure and urinary tract infection. During outpatient follow-up, kidney function had already been deteriorating, but POP was not recognised as a causal factor. A longer duration of ureteral obstruction can lead to irreversible kidney damage, and therefore, timely recognition and intervention is of essence. Even in complex cases with various causative factors for kidney injury, the presence of severe POP and kidney injury should prompt the clinician to exclude this cause.

  • urinary tract infections
  • obstetrics and gynaecology
  • incontinence
  • acute renal failure
  • renal intervention

https://doi.org/10.1136/bcr-2019-229318

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    Footnotes

    • Contributors All authors were involved in the clinical care of the patient. EAL made a first draft of the manuscript which was revised repeatedly by CFlC, EK and MG. CFlC provided clinical care, comments and literature regarding the gynaecological aspect of the case; EK regarding urological aspects and MG about nephrological aspects. EAL implemented all comments and conducted the interview with the patient.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.