Objective: Hemorrhage is a major complication after
percutaneous nephrolithotomy (PCNL). In the current study,
we analyzed the risk factors for severe bleeding after PCNL.
Material and Methods: Medical records of 982 consecutive
patients receiving PCNL at the Department of Urology, the
Third Xiangya Hospital, were reviewed. The type of the stone
included: Solitary (n=471), multiple (n=192) and staghorn
(n=319). The patients had only one kidney in 139 cases. The
puncture site was inferior calyx in 246 cases, middle calyx in 651
cases, and upper calyx in the remaining 85 cases.
Results: The success rate (complete removal of the stone) was
92.8% ,73.4% and 80.9% for solitary, multiple and staghorn
stones, respectively. Severe bleeding occured in 3.25% (8/246)
of the cases with inferior calyx access, and 0.3% (2/651) in cases
with middle calyx access. No severe bleeding occurred in patients
with upper calyx access. The bleeding was controlled successfully
with focal embolization under angiography in all 10 cases.
Conclusions: Severe postoperative bleeding after PCNL is
associated with renal puncture via the inferior calyx, multiple
renal stones and solitary kidney stones.