Haematuria

Hemangioma of the Kidney

“…In light of our experience and that of others [2,[7][8][9], the use of preoperative nephroscopy and peroperative pyeloscopy ought to be mandatory in actively bleeding patients, especially when the angiographic findings are negative.…”

“…Nevertheless, angiography is for the present the best documented diag nostic examination. The introduction of a transurethral nephroscopy and peroperative nephroscopy seems to have improved the diagnosis and/or location of the hemangioma, and consequently they are valuable as guides for surgical therapy [2,[7][8][9].…”

“…Partial nephrectomy is recommended by many authors and has been successfully employed in several cases of minor hemangiomas [2][3][4][5][6][7]9], From a surgical point of view resection is the ideal treatment, and should be considered when the lesion is small and the condition can be recognized with any degree of cer tainty. Otherwise, nephrectomy is justified: (1) because it is usually difficult to identify a hemangioma; (2) when the differential diagnosis includes malignancy; (3) be cause 12% are multiple, and (4) when nephrectomy is performed as a life-saving emergency procedure due to severe bleeding.…”

Haemangioma of the Urinary Tract: Review of the Literature

“…In recent years, 9 cases have been reported in which per-operative nephroscopy established the diagnosis and/or location of the angioma in actively bleeding patients and this is a valuable guide to surgical treatment (Crissey et al, 1980;Gittes and Varady, 1981 ;Aagaard and Hansen, 1985;Garcia et al, 1988). In the light of these results, transurethral nephroscopy or per-operative nephroscopy should be considered in actively bleeding patients, especially if the angiographic findings are negative.…”

“…Most of the reported patients were managed by nephrectomy because of the extreme nature of haematuria and the difficulty in distinguishing the lesion from diseases requiring nephrectomy, such as carcinoma. Partial nephrectomy is recommended by many authors and has been successfully employed in several cases of minor haemangioma (Hagen, 1963;Feczko, 1979;Crissey et al, 1980;Gittes and Varady, 1981;Mitchell1 et al, 1982;Michel et al, 1983;Aagaard and Hansen, 1985). Conservative surgical treatment should be considered when the lesion is small and the condition can be diagnosed with any degree of certainty.…”