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Urolithiasis

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01.06.2014 | Original Paper

Incidence and risk factors of renal hematoma: a prospective study of 1,300 SWL treatments

verfasst von: M. J. Schnabel, M. Gierth, C. G. Chaussy, K. Dötzer, M. Burger, H. M. Fritsche

Erschienen in: Urolithiasis | Ausgabe 3/2014

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Abstract

Shock wave lithotripsy (SWL) is the gold standard for the treatment of upper urinary tract stones. Despite being relatively non-invasive, SWL can cause renal hematoma (RHT). The aim of this study was to determine incidence and risk factors for RHT following SWL. 857 patients were included in a prospectively maintained database. The observation period spans from 2007 to 2012. 1,324 procedures were performed due to kidney stones. Treatment protocol included power ramping and shock wave frequency of 60–90 per minute as well as an ultrasound check within 3 days of SWL for all patients. Patients with RHT were analyzed, and treatment characteristics were compared with the complete population in a non-statistical manner due to the low event count. RHTs after SWL, sized between 2.6 × 0.6 cm and 17 × 15 cm, were verified in seven patients (0.53 %). In four patients, the RHT was asymptomatic. Three patients developed pain after SWL treatment due to a RHT. In one patient surgical intervention was necessary due to a symptomatic RHT, the kidney was preserved. The risk of RHT following SWL treatment of kidney stones is about 0.5 %. Clinically relevant or symptomatic RHTs occur in 0.23 %, RHTs requiring surgical intervention are extremely rare. Older age and vascular comorbidities appear to be risk factors for the development of RHT. The technical characteristics of SWL treatment and intake of low-dose acetylsalicylic acid due to an imperative cardiologic indication do not appear to influence the risk. Prospective studies are warranted.

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Titel: Incidence and risk factors of renal hematoma: a prospective study of 1,300 SWL treatments
verfasst von: M. J. Schnabel
M. Gierth
C. G. Chaussy
K. Dötzer
M. Burger
H. M. Fritsche
Publikationsdatum: 01.06.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Urolithiasis / Ausgabe 3/2014
Print ISSN: 2194-7228
Elektronische ISSN: 2194-7236
DOI: https://doi.org/10.1007/s00240-014-0637-4

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