Bolesław Kuzaka, Cezary Torz, Tomasz Ferenz, Andrzej Borkowski
- Katedra i Klinika Urologii Akademii Medycznej w Warszawie Kierownik kliniki: prof, dr hab. n. med. Andrzej Borkowski
kidney, renal calculi, ESWL, hematomas
- Symptomatic hematomas as a ESWL complication are seen in about 0,6-1% of cases. They occur mainly in patients with hypertension, bleeding disorders, urinary tract infection and obesity. The purpose of this study was to evaluate natural course and treatment of hematomas in patients who underwent ESWL in our clinic between 1988 and 1998. In this period of time 17924 ESWL procedures were performed. In our study the population consisted of 4503 patients referred to our out-patient clinic. This patients were routinely followed-up by US examinations. In our material 10 hematomas were detected (0,2%) and followed-up by US examinations. Six patients were treated conservatively, in 1 patient percutaneous drainage was performed, in 3 patients surgical drainage and pyelolithotomy. We would like to stress, that US is a sensitive method of detecting and monitoring post ESWL hematomas and a majority of these do not require surgical treatment. In cases of increasing the volume of hematoma percutaneous drainage under US-guidance is a sufficient therapeutic method. Surgical treatment should be only limited to the cases with increasing volume of hematoma, despite percutaneous drainage. In our material we have not lost any kidney due to post ESWL hematoma.
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