Huge hematoma following extracorporeal shock wave lithotripsy leading to nephrectomy

Extracorporeal shockwave lithotripsy (ESWL) is a noninvasive and relatively safe method for treating small urinary tract stones, however it may be accompanied with some important complications including hematoma. In this report, we review an instructive and rare case of a patient with massive renal hematoma following ESWL. Despite full conservative management, due to patient instability, emergent exploration and nephrectomy was inevitable. Massive hematoma leading to nephrectomy following ESWL procedure is very rare, but urologists should be aware. Also, if a patient is unstable and don't response to conservative treatment, nephrectomy may be considered after primary resuscitation.