Hospital Readmissions Due to Subcapsular Renal Hematoma After Flexible and Rigid Ureterorenoscopy

Introduction Subcapsular renal hematoma after ureterorenoscopy using a holmium yttrium‐aluminum‐garnet laser is a rare complication. We experienced a case of subcapsular hematoma after ureterorenoscopy. Case presentation The patient was a 56‐year‐old man with a history of hypertension and coronary vasospastic angina, and he was taking antiplatelet drugs. He had the middle and lower calyx stones measured 36 mm in diameter of the right kidney. We performed ureterorenoscopy, which was completed about 2 h without intraoperative complications. We could not remove the stone completely. After the surgery, the patient developed a fever and complained of right back pain. Computed tomography showed several residual stones formed a stone street, obstructing the stent and resulting in grade 3 hydronephrosis. Furthermore, the right subcapsular renal hematoma infection had detected. Percutaneous hematoma drainage and percutaneous nephrostomy were performed. Conclusion Subcapsular renal hematoma after ureterorenoscopy is an uncommon complication but should be kept in mind.

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Subcapsular renal hematoma after ureterorenoscopy

Harada

Yatsuda

Kurahashi

et al. 2022

IJU Case Reports

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Huge perinephric hematoma after ureteroscopy and pneumatic lithotripsy for ureteral stone; A life-threatening rare complication: Case report and review of literature

Alrabadi

Mansi

Alhamss

et al. 2020

International Journal of Surgery Case Reports

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Highlights Ureteroscopy with pneumatic lithotripsy is a relatively safe procedure for the management of ureteral stone disease. The etiology of renal hematomas as a complication of URS and lithotripsy is uncertain yet. This rare complication must be taken into consideration while dealing with patients with obstruction and thin cortex. The risk of bleeding should be included in the risk-benefit counseling prior to ureteroscopic lithotripsy. The management of renal hematoma after ureteroscopic lithotripsy is not standardized yet.

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A rare complication after ureterorenoscopy lithotripsy: Subcapsular renal hematoma

Lu,

Chen,

Cao

et al. 2024

Urologia

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Objective: To evaluate the prevalence, risk factors, clinical manifestations, and outcomes of subcapsular renal hematoma (SRH) following ureterolithotripsy. Patients and Methods: Between January 2014 and December 2023, patients who underwent ureterorenoscopy lithotripsy (URL) at our hospital were retrospectively reviewed. Clinical data including basic information, calculi-related indicators, and perioperative period data were collected. A Student’s t-test was used for continuous data, while a Chi-square test or Fisher’s exact test was utilized for categorical data. Results: A total of 2098 patients treated with URL for ureteric stones were included in this study. The incidence of SRH after URL was 0.52% (11 cases). All SRH cases were confirmed by non-contrast computed tomography, with an average patient age of 55.54 years (range 34–84). The mean stone size in patients with SRH was 10.54 cm (range 0.8–1.5). Patients with SRH had a higher proportion of severe hydronephrosis caused by ureteral stones (54.55% vs 26.07%, p = 0.032) and narrow ureters (45.45% vs 8.04%, p < 0.001) compared to those without SRH. Patients with SRH experienced a longer length of stay, with a significant difference between the two groups (11.64 ± 5.05 vs 3.87 ± 8.12, p < 0.001). Nine patients were managed conservatively without further intervention, while embolization was required in one patient and percutaneous drainage was performed in another. All SRH cases resolved completely during a 4-month follow-up. Conclusions: The incidence of SRH following URL is low, with severe hydronephrosis and narrow ureters identified as risk factors. Most SRH cases can be successfully managed conservatively, although patients with SRH may experience a significant prolongation of their length of stay.

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Hospital Readmissions Due to Subcapsular Renal Hematoma After Flexible and Rigid Ureterorenoscopy

Abstract: What's known on the subject? and What does the study add?

Cited by 3 publications

References 13 publications

Subcapsular renal hematoma after ureterorenoscopy

Subcapsular renal hematoma after ureterorenoscopy

Huge perinephric hematoma after ureteroscopy and pneumatic lithotripsy for ureteral stone; A life-threatening rare complication: Case report and review of literature

A rare complication after ureterorenoscopy lithotripsy: Subcapsular renal hematoma

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