Renal Artery Embolization for Post-Traumatic Hematuria: A Nephron-Sparing Strategy

Objectives: Illustrate the role of embolization as a therapeutic alternative to surgery for renal bleeding.

Clarify the benefits of embolization in preserving renal function.

Materials and methods: Retrospective study including observations of 22 patients with hematuria secondary to renal trauma. The cases collected in our study were diagnosed by abdominal angiography and then underwent renal arterial embolization over a period of 4 years from January 2020 to December 2024.

Results: Our series was characterized by a predominance of males with a sex ratio of 1.2 and an average age of 35 years. All patients presented with uncontrolled gross hematuria and 41% of cases had hemorrhagic shock. The etiologies were: blunt abdominal renal trauma 36% (n=8), open trauma 32% (n=7), iatrogenic trauma post renal biopsy 22% (n=5), and iatrogenic hematuria after percutaneous lithotomy 10% (n=2). The embolization agents used were: coils 64% (n=14), biological glue 27% (n=6), and a combination of coils and biological glue in 9% (n=2).

Our results were satisfactory with immediate cessation of hematuria in all cases, stabilization of hemoglobin, preservation of pre-existing renal function, and near-total preservation of renal parenchyma on imaging control.

Conclusion: Embolization of post-traumatic renal hematuria is an effective alternative to surgery, avoiding partial or sometimes total nephrectomy and deterioration of renal function.