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[Renal hematoma after shockwave extracorporeal lithotripsy]
C Torrecilla Ortiz1, J J Matías López, J Contreras García
1Servicio de Urología, Ciudad Sanitaria y Universitaria de Bellvitge, Hospitalet de Liobregat, Barcelona.
Actas Urologicas Espanolas
|December 31, 1997
Summary
Renal haematomas are a rare but serious complication of shock wave extracorporeal lithotripsy (SWEL). Risk factors include hypertension and haemostatic disorders, necessitating careful patient management.
Area of Science:
- Urology
- Nephrology
- Medical Complications
Context:
- Shock wave extracorporeal lithotripsy (SWEL) is a common procedure for urinary tract stones.
- Renal haematomas are a recognized, albeit infrequent, complication of SWEL.
- Understanding risk factors is crucial for patient safety and procedural optimization.
Purpose:
- To analyze cases of renal haematoma following SWEL.
- To identify potential risk factors associated with post-SWEL renal haematoma.
- To inform clinical practice regarding the prevention and management of this complication.
Summary:
- A retrospective analysis of 12,800 patients undergoing 16,000 SWEL sessions identified 10 cases (0.078%) of renal haematoma.
- Four cases presented with extensive haematoma and haemodynamic compromise, with one fatality due to disseminated intravascular coagulation.
- Hypertension and pre-existing haemostatic alterations were noted in patients who developed haematoma.
Impact:
- Highlights the importance of considering renal haematoma in persistent pain post-SWEL.
- Recommends blood pressure normalization, urinary infection control, and haemostatic correction to mitigate risks.
- Contributes to improved patient selection and peri-procedural care in SWEL.