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Renal access through the inferior calyx is associated with higher risk of severe bleeding after percutaneous

Jing Tan1, Binghai Chen1, Leye He1

  • 1Department of Urology, the Third Xiangya Hospital, Central South University, Changsha, China.

Archives of Medical Science : AMS
|May 22, 2015
PubMed

Insights

Severe bleeding after percutaneous nephrolithotomy (PCNL) is linked to inferior calyx access, multiple stones, and solitary kidneys. Understanding these risk factors is crucial for patient safety during PCNL procedures.

Area of Science:

  • Urology
  • Nephrology
  • Surgical Complications

Background:

  • Hemorrhage is a significant complication following percutaneous nephrolithotomy (PCNL).
  • Identifying risk factors for severe bleeding is essential for improving patient outcomes.

Purpose of the Study:

  • To analyze the risk factors associated with severe postoperative bleeding after percutaneous nephrolithotomy (PCNL).

Main Methods:

  • Retrospective review of medical records for 982 patients who underwent PCNL.
  • Analysis of stone types (solitary, multiple, staghorn) and puncture site (inferior, middle, upper calyx).
  • Inclusion of patients with solitary or functional solitary kidneys.

Main Results:

  • Severe bleeding occurred in 3.25% of cases with inferior calyx access versus 0.3% with middle calyx access.
  • No severe bleeding was observed with upper calyx access.
  • Bleeding was successfully managed with embolization in all reported cases.

Conclusions:

  • Inferior calyx renal access is a significant risk factor for severe bleeding post-PCNL.
  • Multiple renal stones and solitary kidney status are also associated with increased bleeding risk.
  • Targeted strategies for high-risk patients may reduce PCNL-related hemorrhage.
Abstract

Keywords:
bleedingembolizationnephrolithiasispercutaneous nephrolithotomy

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