Predictive factors of delayed bleeding after percutaneous nephrolithotomy requiring angioembolization

Area of Science:

• Urology
• Nephrology
• Surgical Complications

Background:

• Delayed post-percutaneous nephrolithotomy (PCNL) hemorrhage, often due to arteriovenous fistula (AVF) or pseudoaneurysm (PA), is a significant concern.
• Identifying predictive factors for these complications is crucial for patient management.

Purpose of the Study:

• To investigate factors predicting delayed hemorrhage after PCNL caused by AVF or PA.
• To compare predictive factors between AVF and PA.

Main Methods:

• A case-control study involving 72 patients with post-PCNL hemorrhage (AVF/PA) and 216 controls without complications.
• Data collected from 5077 PCNL procedures performed between April 2015 and April 2018.
• Regression analysis used to identify predictive factors.

Main Results:

• A history of diabetes (OR: 2.799) and the presence of renal anomalies (OR: 2.929) were significantly associated with delayed post-PCNL hemorrhage.
• No significant differences in predictive factors were found when comparing AVF and PA.

Conclusions:

• Diabetes and renal anomalies are key predictors of delayed hemorrhage following PCNL.
• Current data do not support differentiating predictive factors for AVF versus PA in post-PCNL hemorrhage.