post-percutaneous nephrostolithotomy (PCNL) bleeding
Can occur from creation of nephrostomy tract when gaining access to the kidney. A nephrostomy tube will usually tamponade the bleeding in the immediate postoperative period. Gross hematuria a week after PCNL should be evaluated with renal arteriogram to evaluate for pseudoaneurysm or arterial-venous fistula which can be treated with embolization.
post-extracorporeal shock wave lithotripsy (ESWL) hematoma
Occurs due to disruption of blood vessels around and near kidney by shock waves. Managed conservatively with expectant management and blood transfusion if needed.
post-ESWL, PCNL, or ureteroscopy treatment urosepsis
Should be treated with intravenous antibiotics and vasoactive medication when needed. Perform imaging to rule out obstruction or abscess.
Occurs due to stone fragments obstructing ureter and subsequent fragments not being able to pass. Patient may need a stent to adequately drain the kidney or a nephrostomy tube which facilitates spontaneous stone passage.
post-ESWL, PCNL, or ureteroscopy ureteric injury
Can occur from scope, laser, or basket causing ureteric damage. Short-term ureteric stent is recommended.
visceral organ injury
Can occur from creation of nephrostomy tract leading to bowel or liver injury.
May occur from creation of the nephrostomy tract with violation of the pleural cavity. Should be treated with a chest tube.
Can be a long-term sequela from ureteric injury. Patient may need subsequent procedure such as dilation or incision of the stricture.
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