Risk Factors Survey for Extracorporeal Shockwave Lithotripsy-Induced Renal Hematoma

Abstract

Renal hematoma is a rare (incidence rate, 0.32%) but possibly lethal complication. The most common symptoms of renal hematoma are severe flank pain and hematuria. A history of hypertension and higher BMI are important predisposing factors to perirenal hematoma.

A Case with Perirenal-Perihepatic-Bony Pelvic Hematoma That Presented with Syncope Following ESWL

“…Dhar et al (13) reported rates of asymptomatic, and symptomatic subcapsular/perirenal hematoma following ESWL as 4.1% and 4%, respectively, whereas these corresponding rates were rreported as 4.1% and 0.7% in another study (5) . Although rarely, complications as perirenal hematomas leading to death have been reported, and the diagnosis can often be overlooked or delayed when USG is preferred instead of CT (14,15) . The chief complaints of post-ESWL hematoma patients are colicky pain and hematuria.…”

“…If a patient who presents with these complaints also has a history of ESWL, more attention must be paid to the appearance of these symptoms, CT should be preferred as the imaging method, and the patient must be monitored (9) . According to studies in the literature, risk factors for post-ESWL subcapsular/ perirenal hematoma include HT, coagulopathies, thrombocytopenia, diabetes mellitus (DM), coronary artery disease, atherosclerosis, obesity, advanced age, presence of calyceal stones, larger stone size, higher number and voltages of shockwaves applied (10,14,16) . Lee et al (14) investigated the risk factors associated with post-ESWL hematoma by comparing the control group without post-ESWL hematoma with post-ESWL hematoma group with regard to age, gender, number of shockwaves, body mass index (BMI), stone size, and HT, and they found that the last three parameters were higher or more common in the hematoma group.…”

Retrograde intrarenal surgery for urinary stone disease in patients with solitary kidney: A retrospective analysis of the efficacy and safety

“…Thus, with respect to SFR, RIRS or PCNL are considered better choices for the treatment of renal stones in solitary kidneys, as long as the procedure is safe and efficient. Furthermore, previous large‐scale studies reported that renal hematoma after SWL occurred in 0.32–0.53% of patients; the shockwave might cause major complications, such as subcapsular hematoma, sepsis and steinstrasse . These complications can be critical for solitary kidney patients, although they are rare.…”

“…Furthermore, previous large-scale studies reported that renal hematoma after SWL occurred in 0.32-0.53% of patients; the shockwave might cause major complications, such as subcapsular hematoma, sepsis and steinstrasse. 20,21 These complications can be critical for solitary kidney patients, although they are rare. Several studies have also reported that SWL was associated with long-term complications, such as worsening renal function or the development of hypertension and diabetes mellitus as a result of the damaging of renal vessels.…”

Successful evacuation of large perirenal hematoma after extracorporeal shock wave lithotripsy (ESWL) ‐ step 1 of the IDEAL recommendations of surgical innovation

“…Several risk factors have been reported. Predisposing factors are hypertension, higher BMI, and age . The recommended treatment is conservative in most cases .…”