Introduction

Uroperitoneum is the collection of urine in the peritoneal or retroperitoneal cavity of a patient. It may occur due to traumatic or iatrogenic events, or following spontaneous ruptures for neoplasms or chronic inflammation at the level of the kidney, ureter, bladder or urethra proximal portion. Within this pathological condition, a biomarker useful for an early diagnosis has been identified, displaying high sensitivity and specificity in the early phases of uroperitoneum. This innovative method exceeds also the limits and complications of the diagnostic techniques currently in use.

Technical features

The innovative method for the diagnosis of uroperitoneum involves two steps: a) the determination of concentration of a biomarker, uromodulin, in a sample collected from abdominal drainage and b) a comparison of that value with the uromodulin concentration in a urine sample. The concentration of uromodulin, determined by a conventional ELISA assay, is infinitesimal (<50 ng) in abdominal drainage samples under physiological conditions, while it reaches measurable concentrations since the early stages of uroperitoneum.​ The method overcomes the limitations shown by the diagnostic  techniques applied to date: i) dosage of creatinine, which proved to be a non-sensitive and reliable marker only in an advanced condition of uroperitoneum, or when the urine in abdomen is very abundant; ii) computed tomography (CT) of the abdomen, diagnostic tool that requires the movement of the patient, usually bedridden in post-surgical phase in intensive care, and the administration of contrast medium, iodized, which subjects the patient to an increased radiological risk.

Possible Applications

• Medical biotechnologies;​
• Surgery: early diagnosis in particular for urological patients in a post-operative phase after urological surgery;​
• Early diagnosis in intensive care units.

Advantages

• Easy detection of uromodulin in biological samples taken from patients in post-surgical conditions;​
• Fast diagnosis of a pathological situation;​
• Limited invasiveness of the diagnostic method;​
• High sensitivity and specificity of the urine presence in the abdomen;​
• No need of expensive reagents and machinery.