SynthesisInternational urology and nephrology2026
Incidence and management outcomes of vascular complications after percutaneous nephrolithotomy: a systematic review and meta-analysis.
Synthesis in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundVascular complications following percutaneous nephrolithotomy (PCNL), although uncommon, may result in significant morbidity. This systematic review and meta-analysis evaluated the incidence, distribution, and management outcomes of vascular complications after PCNL in contemporary practice.
methodsA systematic search of PubMed/MEDLINE, EMBASE, BIOSIS, Google Scholar, and the Cochrane Library identified observational studies reporting vascular complications after PCNL published between 2015 and 2025. Pooled proportions were calculated using a DerSimonian-Laird random-effects model. Statistical heterogeneity was assessed using the I
resultsTen studies met the inclusion criteria. Four studies reporting denominator-level data (10,440 PCNL procedures) were included in the pooled incidence analysis, yielding a vascular complication incidence of 3% (95% CI 2-4%). Among 625 reported vascular complications, pseudoaneurysms were the most frequent lesion (57%), followed by arteriovenous fistulas (29%), arterial lacerations (25%), and arteriocaliceal fistulas (11%); lesion categories were not mutually exclusive. Nine studies reported outcomes following angioembolization (703 cases) and two studies reported conservative management outcomes (204 cases). The pooled success rate was 92% (95% CI 84-98%) for angioembolization and 67% (95% CI 52-80%) for conservative management (p = 0.0013). No procedure-related mortality was reported.
conclusionsVascular complications after PCNL remain infrequent in contemporary practice but may be clinically significant when they occur. Pseudoaneurysm is the most reported lesion. Angioembolization is associated with high success rates in appropriately selected patients, while conservative management remains effective in selected cases. Interpretation of these findings should consider the observational nature of the evidence and substantial heterogeneity across studies.
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