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Urine leak after partial nephrectomy | CION Cancer Clinics
A urine leak means urine is escaping from the cut surface of the kidney into the space around it, rather than all draining down to the bladder. It is an uncommon problem after a partial nephrectomy, not usually dangerous when caught, and most leaks close on their own once the urine is given an easier way out. This page explains why it happens, how it is found and treated, and what to watch for at home. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is a urine leak after a partial nephrectomy?
- Four things that make a leak more likely
- What the team does once a leak is suspected
- Words you may hear on the ward
- What recovery looks like, and what this page cannot tell you
- Four things families say when they hear "leak"
- Common questions about urine leak after partial nephrectomy
The short answer
What is a urine leak after a partial nephrectomy?
A urine leak means that urine is escaping from the cut surface of the kidney into the space around it, instead of all of it draining down to the bladder. It is an uncommon problem after a partial nephrectomy, it is not usually dangerous when it is caught, and most leaks close on their own once the urine is given an easier way out.
Why it can happen after a partial, not a radical
In a radical nephrectomy the whole kidney comes out, so there is no kidney surface left to leak. In a partial nephrectomy the surgeon cuts the tumour out of the kidney and stitches the raw surface closed. If that cut reached the inner collecting system, the funnel where urine gathers before it leaves the kidney, the repair has to seal it. A leak is that seal not holding fully while it heals.
How you would know
Often you would not, at first. It is usually spotted on the ward, because the drain keeps producing more fluid than expected, or the fluid looks like urine. Less often it shows after you go home, as pain and swelling in the side, a fever, or feeling generally unwell.
This page cannot tell you whether you have a leak. That takes a drain-fluid test or a scan, and your team can arrange both quickly.
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After you go home, these cannot wait
Increasing pain or swelling in the side of the operation, a fever or shivering, feeling sick and unable to keep fluids down, or a wound that starts to leak clear or yellow fluid. Ring the number on your discharge sheet or go to the nearest emergency department the same day and say you have had kidney surgery.
Not sure whether this applies to you?
Ask an oncologistWhy it happens
Four things that make a leak more likely
None of them means the surgeon did anything wrong. They are about where the tumour sat.
The tumour sat deep in the kidney
A tumour near the centre, close to the collecting system, means the cut is more likely to open that system.
The tumour was large
A bigger tumour leaves a bigger raw surface to close, and more chance that a branch of the collecting system was opened along the way.
Worth asking before surgery
- Is my tumour close to the collecting system?
- Will a stent be placed as a precaution?
The repair was under strain
Kidney tissue is soft and stitches can cut through a little as it swells in the first days. Slow healing, poor nutrition or diabetes can add to this.
Urine could not drain freely downstream
A clot in the tube to the bladder, or a full bladder, raises the pressure inside the kidney and pushes urine out through the weakest point, which is the repair.
This is why a catheter is kept in for the first day or two.Finding and fixing it
What the team does once a leak is suspected
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Test the drain fluid
A sample from the drain is sent to the laboratory. If it contains far more creatinine, a waste product the kidney filters, than your blood does, the fluid is urine and the leak is confirmed.
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Scan to see the size
A CT scan with dye, timed to show urine leaving the kidney, shows where the leak is and whether a pool of urine has collected. A pool is called a urinoma.
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Give the urine an easier way out
The drain stays in longer, and a catheter is put back in the bladder to keep the pressure low. Many small leaks stop with just this, over days to a few weeks.
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Place a stent if it persists
A thin plastic tube, a DJ stent, is passed up from the bladder to the kidney under a short anaesthetic. It keeps the inner tube wide open so urine takes the easy path and the leak can close.
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Rarely, more than that
If a urinoma is large or infected, a radiologist may place a drain into it through the skin. Going back to theatre is very uncommon.
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On your notes
Words you may hear on the ward
- Collecting system
- The funnel and branches inside the kidney where urine gathers before it flows down to the bladder. A leak means this was opened during surgery.
- Drain creatinine
- The test on the drain fluid. A high result compared with blood confirms the fluid is urine.
- Urinoma
- A pool of leaked urine collecting around the kidney. Small ones are absorbed; larger ones may need a drain.
- DJ stent
- A soft tube with a curl at each end that runs from kidney to bladder. It is removed in a short procedure once the leak has healed.
- Nephrostomy
- A tube placed through the skin straight into the kidney to drain urine. Used only when a stent cannot be placed or has not worked.
Being straight with you
What recovery looks like, and what this page cannot tell you
A leak delays going home rather than changing what the operation achieved. The tumour has been removed and the pathology report is unaffected. What changes is that you carry a drain, and perhaps a stent, for longer than planned, and you come back for an extra scan to confirm it has closed.
Living with a stent for a while
A DJ stent can make you want to pass urine often, and you may see a little blood in the urine or feel an ache in the side when the bladder is full. These are expected and settle when it comes out. Keep drinking well. Tell the team if the ache becomes severe or you develop a fever, because a stent can get infected.
What only a scan can say
Whether a leak has closed cannot be judged by how you feel. The team confirms it with the drain fluid falling to nothing and, usually, a repeat scan before the drain or stent is removed. Do not remove or shorten a drain yourself, and keep the follow-up date even if you feel well.
The kidney itself usually heals fully. A leak does not, on its own, mean that part of the kidney has stopped working.Commonly believed
Four things families say when they hear "leak"
"The surgeon made a mistake."
A leak is a known risk of any partial nephrectomy, and more likely when the tumour sat deep, near the collecting system. Surgeons often place a stent as a precaution when they expect this. It is a healing problem, not an error.
"They will have to open me up again."
Very rarely. Almost all leaks close with a drain, a catheter and, if needed, a stent placed from below without a cut. Going back to theatre is the last option, not the first.
"Urine inside the body will poison me."
Urine is sterile when it leaves the kidney and is absorbed slowly by the body. The concern is infection if a pool sits for a long time, which is why it is drained. It does not poison the blood.
"We should have chosen removal of the whole kidney instead."
A partial nephrectomy is chosen to keep as much kidney as possible, which matters for the rest of your life. A leak that heals in weeks does not undo that benefit. Your team weighed this before recommending it.
Questions we are asked
Common questions about urine leak after partial nephrectomy
How common is a urine leak?
Uncommon, but among the more frequent problems specific to partial nephrectomy. It is more likely with deep or large tumours and less likely with small ones at the edge. Your surgeon can tell you how often it happens in their hands for a tumour in your position.
How long does it take to heal?
Most small leaks stop within days to a few weeks once a drain and, if needed, a stent are in place. Larger leaks can take longer. Your team judges healing by the drain output falling and by a scan, not by a fixed calendar.
Will I go home with the drain still in?
Sometimes, yes. If the leak is small and you are otherwise well, you may be taught to empty and measure the drain bag at home and come back for review. The nurses will show you and your family what to do and what to watch for.
Does the stent hurt?
It can be uncomfortable rather than painful. Needing to pass urine often, a little blood in the urine and an ache in the side when the bladder is full are common. Tablets can ease bladder irritation. Severe pain or fever with a stent needs a call the same day.
Can I eat and drink normally?
Yes. Drinking well keeps the urine dilute and helps a stent stay clear. There is no need to restrict fluids to reduce the leak; the drain and stent are there to handle it.
Will the leak damage the rest of my kidney?
Usually not. Kidney function is checked with blood tests during and after the leak, and in most people it settles back to where it was after the operation. Long-term damage is uncommon, and it is the reason a leak is drained rather than left alone.
Could the leak have been prevented?
Surgeons reduce the chance by careful closure of the collecting system and, where the tumour is deep, by placing a stent during the operation. Even with those steps, some leaks happen.
Does the extra treatment cost more, and is it covered?
A longer stay, a stent or a further scan can add to the bill. Complications arising from an approved operation are usually covered under Aarogyasri, CGHS, ECHS, EHS and cashless insurance, but the hospital may need to seek a fresh approval. Call the helpline and we will check what applies to your cover.
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Dr. Owais Mohammed
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Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Dr. Vinay Mamidala
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Sources
- Cancer Research UK — Surgery for kidney cancer
- American Cancer Society — Surgery for Kidney Cancer
- NHS — Kidney cancer: Treatment
- National Cancer Institute — Renal Cell Cancer Treatment (PDQ) - Patient Version
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Bleeding Risk During Kidney SurgeryThe other problem the cut surface of the kidney can causeWhat Happens in Theatre During a NephrectomyHow a partial nephrectomy differs from removing the whole kidneyDrains, Tubes, Lines and CathetersHow to look after a drain, at hospital and at homeComplications and Red FlagsEvery sign after surgery that needs same-day careRecovery, Eating and Getting Back to LifeWhat a normal recovery looks like once the leak has closed
Talk to us
Drain still producing fluid after a partial nephrectomy?
Call the helpline or send us your discharge summary. A surgical oncologist will tell you what to ask your team and whether it needs to be seen today. One helpline serves every CION centre.