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 retrograde urethrography in five male patients who had undergone pancreatic transplantation. The patients' medical records were reviewed to determine a cause of the extravasations.
Results: Four extravasations occurred at the proximal (deep) bulbar urethra, three at the bulbomembranous junction of the urethra, and one at the distal bulbar urethra. Four of eight cases of extravasation were preceded by recent cystoscopy or placement of a Foley catheter; one case was preceded by possible urethral 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 bulbomembranous junction. If the treating physician is unaware of this condition, diagnosis and institution of appropriate therapy may be delayed. Recent prior urinary tract instrumentation or trauma may be predisposing factors in urinary extravasation.