Reflex anuria post-prophylactic bilateral ureteric catheterisation: a rare postoperative complication

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 12 hours of surgery. A CT of the kidneys, ureters and bladder revealed mild bilateral hydronephrosis and perinephric stranding surrounding the left kidney with no discernible injury to the lower urinary tract. Further investigation did not reveal a clear cause for her anuric state. 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 6-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.