Hospital Readmissions Due To Subcapsular Renal Hematoma After Flexible and Rigid Ureterorenoscopy

Abstract

Objective: The aim of this study is to compare the rates of hospitalization due to subcapsular renal hematoma (SRH) following flexible ureterorenoscopy (FURS) and semirigid ureterorenoscopy (RURS) for the treatment of ureteral and renal stones. Materials and Methods: Patients who have been treated with FURS and RURS at two different institutions between March 2009 and February 2014 were enrolled in the study. Patient files and hospital records were reviewed. Pneumatic lithotriptor was used in RURS while holmium:yttrium aluminium garnet laser was used for FURS. Subcapsular hematoma diagnosis was based on clinical and radiological findings. Comparative analysis of patients with SRH in terms of age, sex, stone size/position, degree of preoperative hydronephrosis, duration of surgery and size of hematoma was done. Results: A total of 1187 patients were found to have undergone ureteroscopic intervention due to ureteal or renal stones. RURS was performed in 992 (83.6%) patients and FURS was performed in 195 patients (16.4%). Of the 992 patients who underwent RURS, postoperative SRH occurred in 6 patients (0.6%). Postoperative SRH occurred in 3 patients (1.5%) who underwent FURS. Of the 9 patients who developed SRH, blood transfusions were needed in three patients and one patient was treated with percutaneous drainage catheter insertion. No patient underwent open surgery. There was no statistically significant difference between the two types of surgeries with regard to age, stone size/localization, degree of preoperative hydronephrosis, duration of surgery and size of SRH (p>0.05). Conclusion: SRH is a rare complication following RURS and FURS. There is no statistically significant difference in the risk for this specific complication between FURS and RURS.