Percutaneous Endoscopic Treatment of Complicated Delayed Bleeding Postpercutaneous Nephrolithotomy: A Novel...

Area of Science:

• Urology
• Interventional Radiology

Background:

• Delayed bleeding post-percutaneous nephrolithotomy (PCNL) is a severe complication, often caused by arteriovenous fistula or arterial pseudoaneurysm.
• Angioembolization is the standard treatment for hemodynamically unstable patients, but contraindications exist.

Purpose of the Study:

• To report an alternative management strategy for post-PCNL hemorrhage when angioembolization is not feasible.
• To evaluate the effectiveness of nephroscopy, nephrostomy, drainage, and tamponade in managing such cases.

Main Methods:

• A case series approach was used to describe the management of patients with delayed post-PCNL hemorrhage.
• The described method involved nephroscopy, nephrostomy tube placement, drainage, and tamponade.
• This approach was employed when angioembolization was contraindicated or not feasible.

Main Results:

• The case series demonstrated the successful management of renal hemorrhage using nephroscopy and nephrostomy with drainage and tamponade.
• This conservative approach provided an effective solution for patients unable to undergo angioembolization.

Conclusions:

• Delayed bleeding after PCNL can be effectively managed with conservative measures including nephrostomy drainage and tamponade.
• This strategy is a viable option when angioembolization is not a feasible treatment due to patient-specific contraindications.