A 45-year-old woman, gravida 4, para 4, is postoperative day 1 from a robotic-assisted total laparoscopic hysterectomy. By 02:00, she had produced only 10 mL of urine output over the prior 2 hours and a total of 50 mL over the past 7 hours. The surgery began at 15:00 and required 4.5 hours, the majority of which was spent dissecting the bladder free of the uterus and cervix. There was difficulty with the left uterine artery, leading to an estimated blood loss of 1500 mL. The patient was briefly hypotensive and responded to a large fluid bolus. At the end of the surgery, the operative field was dry and cystoscopy revealed vigorous jets from both ureters. Her starting hemoglobin was 11.2 g/dL. A repeat hemoglobin was planned for 02:30. Her urine has been blood tinged since the surgery. The patient has no medical problems and has had four previous cesarean deliveries. She takes no medications.