Complications
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 haematuria a week after PCNL should be evaluated with renal arteriogram to evaluate for pseudoaneurysm or arterial-venous fistula which can be treated with embolisation.
Occurs due to disruption of blood vessels around and near kidney by shock waves. Managed conservatively with expectant management and blood transfusion if needed.
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 or nephrotomy tube to adequately drain the kidney or a nephrostomy tube which facilitates spontaneous stone passage.
Can occur from scope, laser, or basket causing ureteric damage. Short-term ureteric stent is recommended.
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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