Delayed Haematuria after Percutaneous Nephrolithotripsy and its Management

Abstract

Objective: To evaluate the risk factors and management of patients developed delayed haematuria after Percutaneous nephrolithotripsy (PCNL). Methods: Data taken from 75 patients, who underwent PCNL procedures between January 2013 to June 2017. Among them 53 were male, 22 were female. Five patients presented with delayed haematuria. They were hospitalized and initially managed conservatively by bed rest and conservative treatment. Diagnostic imaging with ultrasound and non-contrast abdominal CT and serial follow up with blood tests were carried on. Angiography was performed, if indicated, to evaluate and treat possible vascular injury. All affected patients had risk factors for haematuria. Out of five, four patient had angiography, in two patients it confirm vascular injury and treated accordingly, while two were normal and one refuse for angiography. Conclusion: Delayed hematuria is one of rare and serious outcome of PCNL, but can be safely managed without serious consequences. Mostly it is secondary to vascular complication e.g., pseudo aneurysms. Presence of risk factors increases chance of haematuria. Conservative treatment is effective. In responders angiography; and embolization can be done, whenever indicated.