Renal hematomas after extracorporeal shock-wave lithotripsy (ESWL)

• Published in: Actas urologicas españolas Vol. 33; no. 3; pp. 296 - 303
• Main Authors: Pastor Navarro, Héctor, Carrión López, Pedro, Martínez Ruiz, Jesús, Pastor Guzmán, José Ma, Martínez Martín, Mariano, Virseda Rodríguez, Julio A
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.03.2009
• Subjects: Adult; Aged; Female; Hematoma - etiology; Humans; Kidney Diseases - etiology; Lithotripsy - adverse effects; Male; Middle Aged
• ISSN: 0210-4806
• DOI: 10.1016/S0210-4806(09)74144-0

The use of fragmentation due to shock- waves as a treatment of urinary stone was one of the most important therapeutics findings in the history of urology. It's the first election treatment for most of the calculus at renal and urethral location due to the fact that it is a low invasive treatment and it has a few number of complications, but this method also has a few negative side effects, it can caused a more or less important traumatic lesion at the organs which crosses the shock-waves, including the kidney where it can caused a small contusion or renal hematoma with different resolution and treatment. We reviewed 4815 extracorporeal shock-wave lithotripsy that we performed in our department in which we found six cases with subcapsular and perirenal hematoma which we followed up and treated. After the urological complications (pain, obstruction and infection) the renal and perirenal hematic collections are the most frequent adverse effects of shock-waves used in lithotripsy, these are related to the power of energy used and patient age. Between the years 1992-2007 we performed 4.815 extracorporeal shock-wave lithotripsy finding seven cases of severe hematoma, less then 1%. Treatment of these complications is usually not aggressive though sometimes it is necessary to perform surgical drainage and even nephrectomy.