[Renal Subcapsular Hematoma after Transurethral Ureterolithotripsy]

Area of Science:

• Urology
• Nephrology
• Surgical Complications

Background:

• Subcapsular renal hematoma is a known complication of certain kidney stone treatments.
• While associated with extracorporeal shock wave lithotripsy and percutaneous nephrolithotripsy, its occurrence after transurethral ureterolithotripsy (TUL) is less understood.
• There is a lack of consensus regarding risk factors, patient outcomes, and optimal management strategies for post-TUL subcapsular renal hematoma.

Purpose of the Study:

• To investigate the clinical characteristics and outcomes of patients who develop subcapsular renal hematoma following transurethral ureterolithotripsy (TUL).
• To provide insights into the management and prognosis of this specific surgical complication.

Main Methods:

• A retrospective analysis was conducted on 1,235 patients who underwent TUL between October 2011 and December 2020.
• Cases of subcapsular renal hematoma diagnosed post-surgery were identified and their clinical data reviewed.
• Key parameters including patient demographics, operation time, hematoma size, and hemoglobin levels were analyzed.

Main Results:

• Five cases (0.40%) of subcapsular renal hematoma were identified among the 1,235 TUL patients.
• The median age of affected patients was 63 years.
• Median hematoma diameter was 8.2 cm, with a median hemoglobin decrease of 1.6 g/dL.
• All five patients were managed conservatively, with one requiring a blood transfusion; no invasive interventions like embolization were necessary.

Conclusions:

• Subcapsular renal hematoma following TUL is a rare but potentially manageable complication.
• Conservative management appears to be a viable strategy for these cases.
• Close monitoring of patients post-diagnosis is crucial to ensure timely intervention if required.