title: Grade 3a Clavien grade complication following percutaneous nephrolithotomy. Related factors and review of the literature.
abstract: OBJECTIVE
  We review the literature about bleeding complications of percutaneous nephrolithotomy (PCNL) and the application of the modified Clavien system classification.
  
  
  METHODS
  We present a 38 year old man who underwent left PCNL with acute severe hematuria during the immediate postoperatory time. We review the literature and analyze the usefulness of the modified Clavien system to grade perioperative complications.
  
  
  RESULTS
  Conservative management was insufficient so we had to perform arteriography and superselective embolization to solve the acute arterial bleeding. According to Clavien's classification, our case would be included within the grade 3a group complications.
  
  
  CONCLUSIONS
  The complications following a PCNL are not uncommon. However most of them are not severe. The modified Clavien system, used for classifying complications after performing PCNL, can be useful for reporting results in an objective and replicable way.
authors.affiliation: Servicio de Urologia . Hospital Universitario 12 de Octubre. Madrid .Spain.
authors.forename: Natalia
authors.initials: N
authors.lastname: Miranda-Utrera
authors.forename: Manuel
authors.initials: M
authors.lastname: Pamplona Casamayor
authors.forename: Susana
authors.initials: S
authors.lastname: Borruel Nacenta
authors.forename: R
authors.initials: R
authors.lastname: Villar Esnal
authors.forename: Rafael
authors.initials: R
authors.lastname: Diaz Gonzalez
mesh_terms: D000328:Adult; D004621:Embolization, Therapeutic; D006417:Hematuria / Q000209:etiology; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D012077:Renal Artery / Q000601:surgery; D014546:Urinary Catheterization / Q000009:adverse effects