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Related Experiment Videos

Pyonephrosis: diagnosis and treatment.

M St Lezin1, R Hofmann, M L Stoller

  • 1Department of Urology, University of California School of Medicine, San Francisco.

British Journal of Urology
|October 1, 1992
PubMed
Summary
This summary is machine-generated.

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Percutaneous nephrostomy drainage is a safe and effective method for diagnosing and treating pyonephrosis, even when symptoms are absent. This procedure offers valuable diagnostic and therapeutic benefits for kidney infections.

Area of Science:

  • Urology
  • Nephrology
  • Infectious Diseases

Background:

  • Pyonephrosis, a severe kidney infection, often presents with variable symptoms, making diagnosis challenging.
  • Traditional diagnostic methods may be insufficient, necessitating alternative approaches.
  • Percutaneous nephrostomy drainage is an established intervention for obstructive uropathy.

Purpose of the Study:

  • To review the diagnostic and therapeutic utility of percutaneous nephrostomy drainage in pyonephrosis cases.
  • To evaluate the clinical presentation and outcomes of patients with pyonephrosis.
  • To assess the role of percutaneous drainage in cases with and without nephrolithiasis.

Main Methods:

  • Retrospective review of 23 confirmed pyonephrosis cases initially treated with percutaneous nephrostomy drainage.

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  • Analysis of patient presentations, diagnostic imaging (ultrasonography), and urine culture results.
  • Evaluation of treatment outcomes, including the need for further interventions like nephrectomy.

    • Main Results:

    • Presentations varied widely, with fever, flank pain, and leukocytosis often absent.
    • Ultrasonography was diagnostic in only 3 of 12 patients.
    • 17 patients had associated nephrolithiasis; 5 required nephrectomy.
    • Renal urine cultures provided additional data in 11 cases compared to bladder cultures.
    • Percutaneous drainage proved safe, quick, and effective.

    Conclusions:

    • Percutaneous nephrostomy drainage is a valuable tool for both diagnosis and treatment of pyonephrosis.
    • The procedure is effective even in atypical presentations and can guide further management.
    • Associated nephrolithiasis impacts outcomes, but percutaneous drainage remains a crucial initial step.