Volume 14, Supplement 1
Original Article / Published: April 2026
DOI: https://www.doi.org/10.57045/jemis/1410426.pp30
D. Dichov, S. Marangozov, N. Kolev, T. Adem, K. Girov
Clinic of Vascular Surgery, Department of Surgery, Military Medical Academy, Sofia, Bulgaria
Abstract
Introduction: Severe hematuria after removal of a double J-stent is an uncommon but extremely serious complication. Rarely, the cause of the bleeding is vascular pathology, which requires prompt diagnosis and treatment.
Aim: To present a clinical case of severe hematuria, which occurred after removal of a ureteral stent and was suspected of vascular origin, which was successfully diagnosed and managed by an endovascular approach.
Clinical case: A woman was admitted to our clinic with macroscopic hematuria shortly after removal of a ureteral double J-stent. The hematuria was bright red and persisted for several days, suggesting possible involvement of a major blood vessel.
Treatment: An endovascular technique was used. The iliac artery was cannulated and a covered stent was deployed to isolate the affected vascular segment from the adjacent ureter. Following this, selective renal embolization was performed to control suspected intrarenal bleeding.
Results: The combined approach resulted in cessation of the hematuria and stabilization of the patient’s condition. No complications were observed.
Conclusion: Endovascular treatment allows for rapid, effective and minimally invasive management, reducing surgical risk. Therefore, it is a good option in cases where severe hematuria is due to complex vascular pathology requiring a combined approach.
Keywords:
hematuria, double J-stent, renal embolization, covered stent
How to cite this article:
D. Dichov, S. Marangozov, N. Kolev, T. Adem, K. Girov. Endovascular management of life-threatening hematuria following ureteral stent removal. Journal of Endourology and Minimally Invasive Surgery (Bulgaria), 2026; 14(1): 30-31
Corresponding author:
Dr Dilyan Dichov
Military Medical Academy of Sofia, Department of Surgery, Clinic of Vascular Surgery 3, ”Georgi Sofiiski” blvd., Sofia 1606
Email: dilyandichov@gmail.com