Delayed bleeding after percutaneous nephrolithotomy

ABSTRACT

2502 patients with renal stones were treated by PCNL at our center over a period of 13 years starting from 1984. Eighty-four patients were readmitted with delayed bleeding [3.4%]. All but 19 patients [0.8%] were treated conservatively. These 19 patients proved to have significant vascular injuries as documented by selective arteriography in the form of pseudoaneurysms and/or arteriovenous fistulae [18 patients] or vascular lacerations [1 patient]. Embolization with platinum microcoils and/or absolute alcohol controlled bleeding in all but one patient. He was explored, and nephrectomy was decided to save him. Follow-up data of up to 78 months [46.2+20.5] revealed that embolization was a safe procedure with minimal late sequelae. Renal function remained stable. Two patients, however, developed hypertension. The study revealed that the incidence of delayed bleeding after PCNL due to a significant vascular lesion was low [0.8%]. Arteriographic embolization is not only a life-saving procedure but also a kidney-sparing technique