[Hemorrhagic complications during percutaneous nephrolithotomy. Retrospective studies of 772 cases].
OBJECTIVE
To evaluate the haemorrhagic complications of PCNL, to analyse their management and to identify predisposing factors.


METHODS
Out of a series of 772 cases of PCNL, 18 patients developed severe haemorrhage requiring a haemostatis procedure (2.3%): 13 males and 5 females with a mean age of 57 years (38-79), and one case on a solitary kidney. The mean time to onset of haemorrhage was 18 days (--48 days).


RESULTS
Three nephrectomies for haemostatis were performed at the beginning of our experience. Renal arteriography was performed in 15 patients and was abnormal in 13 patients, showing 3 arteriovenous fistulas, 8 false aneurysms, 3 arteriolar injuries. All these vascular abnormalities were successfully treated by highly selective embolization. In 2 cases, arteriography was normal with a spontaneously favourable course. Comparison of the 2 groups of PCNL, with haemorrhage versus without haemorrhage, failed to demonstrate any risk factors.


CONCLUSIONS
Severe haemorrhage following PCNL is a rare complication, but impossible to predict. Selective embolization allows control of bleeding and currently constitutes the treatment of choice.
Gremmo
E
E
Service d'Urologie, CHU de Bordeaux, France.
Ballanger
P
P
Doré
B
B
Aubert
J
J
D000328:Adult; D000368:Aged; D000792:Angiography; D004621:Embolization, Therapeutic; D005260:Female; D006470:Hemorrhage / Q000145:classification / Q000209:etiology* / Q000628:therapy; D006489:Hemostatic Techniques; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis* / Q000601:surgery*; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D011183:Postoperative Complications; D012077:Renal Artery / Q000000981:diagnostic imaging; D012189:Retrospective Studies
Complications hémorragiques au cours de la néphrolithotomie percutanée. Etude rétrospective à partir de 772 cas.