Subcapsular Renal Hematoma after ureteroscopic lithotripsy- an unusual issue beyond doubts

Dr Amiya Shankar Paul; Dr Goutam Kumar Mishra; Dr Arshad Hasan; Dr Gyan Prakash Singh

Volume : VII, Issue : VIII, August - 2018

Subcapsular Renal Hematoma after ureteroscopic lithotripsy- an unusual issue beyond doubts

Dr Amiya Shankar Paul, Dr Goutam Kumar Mishra, Dr Arshad Hasan, Dr Gyan Prakash Singh

Abstract :

Subcapsular renal hematoma is well known complication associated with extracorporeal shockwave lithotripsy (ESWL) and percutaneous nephrolithotomy (PCNL) but after ureteroscopic lithotripsy (URSL) it rarly occurs. We reviewed our center’s experience of post–URSL perinephric hematoma from 2012 to 2018. 872 URSLs using 7.5/9 F rigid ureteroscopes were performed.Documented operative information, postoperative presentation of symptoms, changes in blood parameters, USG findings, and subsequent management of complications were reviewed. Associated perioperative information on patient’s preoperative morbidity, renal function, stone characteristics, and degree of hydroureteronephrosis were noted. Post–URSL subcapsular hematoma was diagnosed in 3 of 872 (0.34%) patients in which two managed by ultrasonography–guided percutaneous aspiration and one by conservatively. A strong suspicion is needed for a rare complication when patients present with significant loin pain and feverafter URSL. The management of post–URSL subcapsular hematomas needs to be customized for each patient with conservative approach even reveals a good outcome.