Renal artery pseudoaneurysm presenting in a single functioning kidney with prior partial nephrectomy following flexible ureterorenoscopy: a case report

Renal artery pseudoaneurysm (RAP) formation following flexible ureterorenoscopy (FURS) with laser lithotripsy is rare. Previous kidney surgery places patients at an increased risk due to potential vascular injury associated with renal intervention. In our case, a 62-year-old man with a single functioning right kidney and a history of right partial nephrectomy presented 10 days following FURS with holmium laser lithotripsy, complaining of gross hematuria. Attempted conservative management failed. Renal arteriography was done, which revealed a RAP that was managed with selective angioembolization. RAP following FURS can be serious if not managed properly. Most cases present with late gross hematuria. RAP can usually be demonstrated on renal arteriography. Selective angioembolization is the definitive treatment.