TY - JOUR
T1 - Percutaneous Nephroureteral Tube
T2 - A Useful Tool for Management of Intractable Hematuria
AU - Spradling, Kyle
AU - Elliott, Christopher S.
AU - Vo, Hong
AU - Reese, Jeffrey
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/4
Y1 - 2019/4
N2 - Objective: To describe our experience using percutaneous nephroureteral (PCNU) tube placement for the management of intractable gross hematuria. Methods: We identified patients at our institution who underwent PCNU tube placement from August 2011 to October 2017 for management of gross hematuria who had previously failed management with manual irrigation, continuous bladder irrigation, and cystoscopy with clot evacuation. The primary outcome measured was cessation of bleeding obviating the need for further blood transfusion in a 30 day follow-up period. Results: Six patients were treated with PCNU tube placement for intractable hematuria from either malignant or nonmalignant etiologies. In all patients after PCNU tube placement, hematocrit value remained stable, there were no further transfusions requirements within 30 days, and no immediate or periprocedural complications were encountered. In no instance did a PCNU become obstructed by blood clots and in all cases the bladder and both kidneys were adequately drained. Conclusion: In patients with hematuria refractory to conventional management techniques, the placement of a PCNU tube allows for cessation of bleeding, successfully diverts urine with no immediate complications and is not subsequent to clot obstruction of the tube. The use of PCNU tube is a viable treatment in the algorithm of intractable hematuria, specifically before resorting to more morbid and potentially irreversible treatments.
AB - Objective: To describe our experience using percutaneous nephroureteral (PCNU) tube placement for the management of intractable gross hematuria. Methods: We identified patients at our institution who underwent PCNU tube placement from August 2011 to October 2017 for management of gross hematuria who had previously failed management with manual irrigation, continuous bladder irrigation, and cystoscopy with clot evacuation. The primary outcome measured was cessation of bleeding obviating the need for further blood transfusion in a 30 day follow-up period. Results: Six patients were treated with PCNU tube placement for intractable hematuria from either malignant or nonmalignant etiologies. In all patients after PCNU tube placement, hematocrit value remained stable, there were no further transfusions requirements within 30 days, and no immediate or periprocedural complications were encountered. In no instance did a PCNU become obstructed by blood clots and in all cases the bladder and both kidneys were adequately drained. Conclusion: In patients with hematuria refractory to conventional management techniques, the placement of a PCNU tube allows for cessation of bleeding, successfully diverts urine with no immediate complications and is not subsequent to clot obstruction of the tube. The use of PCNU tube is a viable treatment in the algorithm of intractable hematuria, specifically before resorting to more morbid and potentially irreversible treatments.
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U2 - 10.1016/j.urology.2019.01.003
DO - 10.1016/j.urology.2019.01.003
M3 - Article
C2 - 30654139
AN - SCOPUS:85060875683
SN - 0090-4295
VL - 126
SP - 232
EP - 235
JO - Urology
JF - Urology
ER -