Renal Pelvic Hematoma Following Robot-Assisted Pyeloplasty: Two Case Reports

Renal pelvic hematoma is an uncommon but important complication after robot-assisted pyeloplasty (RAP), with few reports in the literature. Here, we report two cases of renal pelvic hematoma following RAP: A 9-year-old girl (Case 1) and a 25-year-old man (Case 2), both diagnosed with left ureteropelvic junction obstruction. Both underwent transperitoneal Anderson-Hynes pyeloplasty using 5-0 absorbable monofilament sutures. Postoperative imaging revealed renal pelvic hematoma in each case. Both patients remained hemodynamically stable and were managed conservatively. In Case 1, the hematoma and urine were aspirated through a 6 Fr ureteral catheter, whereas in Case 2, symptoms resolved spontaneously. Follow-up imaging demonstrated preserved renal function and improvement of hydronephrosis in both cases. Renal pelvic hematoma after RAP is rare but can be managed conservatively in stable patients. Careful intraoperative hemostasis and awareness of this complication are essential to ensure favorable outcomes.