[Characteristics of renal hemorrhage after percutaneous nephrolithotomy and the timing of selective embolization: a report of 13 cases].
OBJECTIVE
To investigate the characteristics of severe renal hemorrhage after percutaneous nephrolithotomy (PNL) and timing of selective transarterial embolization(TAE) .


METHODS
Between May 2005 and March 2010, superselective renal angiography was used to control severe bleeding in 15 of 1418 cases (1520 PNL procedures, 1.06%). In the 15 cases, superselective renal angioembolization was used to control severe bleeding in 13 (0.92%) . The medical records of all the patients who underwent renal angiography and angioembolization were reviewed.


RESULTS
Severe bleeding cases after PNL were divided into 3 types according to the clinical characteristics: type I (urgency type), type II (intermittence type) and type III (persistent slow type). There were 3 patients in type I, 6 in type II and 6 in type III. All the patients had a normal coagulation profile before surgery. A total of 11 patients (84.6%) underwent the first-time successful embolization and 2 (15.4%) the second-time successful embolization. The longer time between angioembolization and bleeding was, the more blood loss and transfusion volume were, except for 1 patient in type II . Temporality serum creatinine abnormality was found in 2 patients, one with a solitary kidney patient and the other with angioembolization for both renal bleeding.


CONCLUSIONS
TAE is a minimally invasive, safe, simple, and highly effective modality for the management of post PNL renal bleeding. This option should be considered early in the management of these cases,especially for Urgency type bleeding.
Xiong
Liu-lin
LL
Department of Urology, Peking University People's Hospital, Beijing 100034, China.
Huang
Xiao-bo
XB
Ye
Xiong-jun
XJ
Li
Jian-xing
JX
Yang
Bo
B
Xu
Qing-quan
QQ
Ma
Kai
K
Chen
Liang
L
Wang
Xiao-feng
XF
Gao
Jian
J
Jin
Long
L
Chen
Lei
L
D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery; D007674:Kidney Diseases / Q000209:etiology / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy*; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000293:injuries; D013997:Time Factors