DOI: 10.36347/sjams.2019.v07i05.005

Pages: 1697-1701

Percutaneous nephrolithotomy (PCNL) is the first line treatment for renal stones. Hemorrhage is the most significant complication of PCNL. Purpose of this study is to analyze various risk factors associated with hemorrhage in percutaneous nephrolithotomy (PCNL). Medical records of 295 patients, who underwent PCNL between March, 2017 and February, 2019 were analyzed retrospectively. Various patient related risk factors like age, sex, body mass index, diabetes, urinary tract infection, history of previous renal surgery; stone related risk factors like, stone size and number, hydronephrosis and surgery related risk factors like surgery duration, number of tracts, tract size, pelvicalyceal perforation were assessed. Statistical analysis was done using univariate and multivariate analysis. Average drop in hemoglobin after PCNL was 1.88±1.52 g/dl. Blood transfusion was required in 20 patients (6.7%). Mean operating time was 73.71±22.54 minutes. Presence of diabetes mellitus, urinary tract infection, large stone size, multiple tracts and pelvicalyceal perforation were independent risk factors for hemorrhage. Most of the patients were managed conservatively with strict bed rest, intravenous crystalloids and antibiotics with or without blood transfusion. One patient (0.33%) was diagnosed with pseudoaneurysm on angiography. According to this study, diabetes mellitus, urinary tract infection, large stone size, multiple tracts and pelvicalyceal perforation are independent risk factors for hemorrhage. Further large prospective studies are required for assessment of risk factors for bleeding in PCNL.