Korean J Med.  2016 May;90(5):464-467. 10.3904/kjm.2016.90.5.464.

Septic Shock with Acute Kidney Injury due to Obstructive Uropathy by Uterine Prolapse, Documented in a Urodynamic Study

• Choi SH
• Park SM
• Kim EJ
• Yoo JH
• Jeong H
• Cho Y

• KMID: 2163245
• DOI: http://doi.org/10.3904/kjm.2016.90.5.464

Abstract

A 76-year-old woman with high fever and low blood pressure was admitted to the intensive care unit with a diagnosis of septic shock of unknown cause. A meticulous physical examination revealed a uterine prolapse with marked lower abdominal distention, suggesting urinary retention. After manual reduction of the uterine prolapse and insertion of a urinary catheter, the patient was managed with antibiotics for a presumed urinary tract infection. Escherichia coli was cultured on urine and blood culture media. Several days later the patient underwent a gynecological operation (anterior-posterior colporrhaphy) to correct the underlying cause of the obstructive uropathy. A preoperative and postoperative urodynamic study demonstrated marked urinary retention due to uterine prolapse. Pelvic organ prolapse including the uterus is not rare in older women. However, this common gynecological problem can cause lethal obstructive uropathy, such as uroseptic shock and acute kidney injury, if complications are present.

Keyword

Pelvic organ prolapse; Shock, Septic; Urodynamics

MeSH Terms

Acute Kidney Injury*
Aged
Anti-Bacterial Agents
Culture Media
Diagnosis
Escherichia coli
Female
Fever
Humans
Hypotension
Intensive Care Units
Pelvic Organ Prolapse
Physical Examination
Shock
Shock, Septic*
Urinary Catheters
Urinary Retention
Urinary Tract Infections
Urodynamics*
Uterine Prolapse*
Uterus
Anti-Bacterial Agents
Culture Media