A.Ts. Borzhievsky, M.M. Chaplya, O.I. Slabyy, V.M. Artyshchuk, A.P. Rumyantseva

Management of hemorrhagic complications associated with percutaneous nephrolithotomy

In this article results of treatment of 1952 patients with urolithiasis, who underwent 2218 percutaneous nephrolithotomy. Among the patients was 1045 (53.5%) men and 907 (46.5%) women. The age of patients ranged from 15 to 79 years. Hemorrhagic complications occurred in 63 (2.8%) cases. Intraoperative - in 4 (6.4%), early postoperative - 52 (82.5%), late postoperative - in 7 (11.1%). Most bleeding (49 (77.8%)) were eliminated conservative, and did not require additional instrumental methods of treatment. In 11 (17.5%) cases occurred formation of subcapsular hematoma, and 3 (4.8%) - perirenal hematoma. In 9 (14.3%) cases, patients had to fulfill superselective embolization of the renal artery branches (during arteriography was diagnosed arteriovenous fistula in 4 (6.4%), and in 5 (7.9%) - branch of the renal artery aneurysm). Re-embolization required in 2 (3.2%) cases. Nephrectomy for bleeding after percutaneous nephrolithotomy performed in 5 (7.9%). In 1 (1.6%) cases - due to bleeding from the renal artery aneurysm. Lethal outcome in1 (1.6%) cases (patient wis thrombocytopenic purpura).