title: Novel technique for the treatment of large subcapsular renal hematoma: combined use of percutaneous drainage and urokinase injection.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of combined use of percutaneous drainage and urokinase injection to treat patients with large subcapsular renal hematoma.
  
  
  METHODS
  We retrospectively analyzed the data of 20 patients with large subcapsular renal hematoma who were treated with percutaneous drainage and urokinase at our institutes between 2002 and 2010. Percutaneous drainage of the hematoma was performed after bleeding stopped. Then, urokinase was injected into the hematoma cavity per our protocol every 3 days. During the treatment and follow-up period, the diameter of hematoma was assessed by ultrasonography and enhanced computed tomography (CT) in all cases. Complete blood count, serum creatinine and blood pressure were evaluated as well. Follow-up periods ranged from 12 to 60 months (mean 24.1 ± 11.5 months).
  
  
  RESULTS
  Percutaneous renal hematoma drainage combined with urokinase injection was successfully performed in all the patients. After sufficient drainage, all of the patients were free from their symptoms. The average time to pain relief was 10.8 ± 2.1 days after percutaneous drainage, and the total duration of drainage was 28 ± 5.1 days. Relative to baseline, there was reduction in the diameter of hematoma evaluated by the enhanced CT scan after treatment (from 11.7 ± 3.1 to 2.8 ± 1.0 cm). During long-term follow-up, active bleeding, hypertension, renal function impairment or infectious complications were not found.
  
  
  CONCLUSIONS
  This study revealed that combined use of percutaneous drainage and urokinase injection was a safe and effective treatment for patient with large subcapsular renal hematoma.
authors.affiliation: Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277, Jiefang Road, Wuhan, 430022, Hubei, China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Shen
authors.forename: Wenqiang
authors.initials: W
authors.lastname: He
authors.forename: Dong
authors.initials: D
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: Pan
authors.forename: Wencheng
authors.initials: W
authors.lastname: Li
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Han
authors.forename: Bing
authors.initials: B
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D004322:Drainage / Q000379:methods; D005260:Female; D006406:Hematoma / Q000473:pathology / Q000628:therapy*; D006801:Humans; D015552:Injections, Intralesional; D007674:Kidney Diseases / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D014568:Urokinase-Type Plasminogen Activator
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