Login to Access Video or Poster Abstract: MP30-19
Sources of Funding: none

Introduction

Previous reports describe renal auto-transplantation (RAT) as a possible therapy for loin pain hematuria syndrome (LPHS) with reported successful pain relief ranging between 25-65%. We propose a percutaneous renal hilar blockade (RHB) can help predict when a LPHS patient should be referred for RAT. Herein we describe our one year follow up of this study.

Methods

A pre-procedure pain assessment was performed using a 0-10 numeric pain rating scale. Percutaneous hilar block was then performed with the patient in the prone position on the CT gantry. A post-procedure pain assessment was then performed. If their pain score was reduced >50% immediately after the RHB then they were referred for RAT. Before surgery and one year after surgery a quality of life survey was given to each RAT patient. The survey questions collected information related to demographics, medical history, and the patients’ current medical state. In addition to this survey, the patients were also asked to fill out the Beck Depression Inventory Scale, an internationally recognized instrument for assessing the presence and severity of depression symptoms._x000D_

Results

During a three-year period 24 patients were diagnosed with LPHS by our urologist and were referred for RHB. Of the 24 patients that received RHB, 20 had relief of pain with a >50% reduction in pain scores. Pre-RHB average pain score was 7/10 with post-RHB score being 0.7/10 in patients that had >50% reduction in pain score. 13 of the patients who responded then proceeded to RAT, 3 responded but were denied by insurance; 4 responded, but did not receive RAT because they are still in work up; 4 did not respond to the block and were referred to a pain clinic. Of the 13 patients that received RAT, 6 patients have had at least one year follow up after RAT. All 6 patients underwent a successful RAT and currently have a functioning graft (Table). Their 1 year f/u post RAT assessment of pain level was an average of 2.3 down from an average 7 for a 67% reduction at 1 year.

Conclusions

Successful RAT for LPHS relies on the appropriate diagnosis. RHB should be considered as a tool to define LPHS patients appropriate for RAT.

Funding

none