Long-term radiographic and functional outcome of extracorporeal shock wave lithotripsy induced perirenal hematomas.

Abstract

We determined the long-term radiographic and functional outcome of extracorporeal shock wave lithotripsy (ESWL) related perirenal hematomas. We followed 19 patients with 21 ESWL induced hematomas for 4 to 61 months (mean 19.6) after ESWL with serial ultrasound, blood pressure and serum creatinine determinations. Complete radiographic resolution of the hematoma was evident in 18 cases (85.7%), while 2 (9.5%) were significantly smaller and 1 (4.8%) remained unchanged. Of 10 patients who were normotensive before ESWL none experienced sustained new onset hypertension. Of 9 patients with preexisting hypertension none had a sustained exacerbation. Finally, during followup serum creatinine levels overall remained unchanged from pre-ESWL values. We conclude that, by far, the most likely outcome for patients with ESWL related hematomas is spontaneous radiographic resolution within 2 years without clinically evident adverse effects on blood pressure or renal function.