Perinephric Hematoma Following Ureteroscopy and Holmium Laser Lithotripsy

We present a case of a ureteropyeloscopy with holmium laser lithotripsy for a 5mm distal ureteral calculus that was complicated by perinephric hemorrhage despite utilization of a ureteral access sheath and the absence of any bleeding disorders. Conservative management was elected and the patient did not require transfusion of blood products. We believe this is the first case of perinephric hemorrhage under these circumstances and suggest that surgeons inform their patients of the low risk of bleeding complications with ureteroscopy.