Urinary tract complications of anticoagulation therapy; “Pseudotumour” of the kidney

Haematuria is the complication most frequently encountered during anticoagulation therapy. The causes of haematuria during anticoagulation therapy often remain obscure and apparently are reversible, once the treatment is stopped. There are, however, several types of urinary tract complications that can be recognised and for which proper measures must be taken. (1) Intrarenal haematoma: this type of parenchymal bleeding may present as a mass lesion or “pseudotumour”. These lesions usually resolve promptly following cessation of therapy and require no specific treatment. It is important that they be recognised and not confused with a true tumour mass. (2) Intraluminal haemorrhage: this type of bleeding may cause colic and may progress to urinary tract obstruction. The clots that form may resolve spontaneously or surgical removal may be necessary. (3) Retroperitoneal haemorrhage: haemorrhage in this area may cause ureteral obstruction and surgical intervention seems necessary.