Pyelonephritis interventions
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
Overview
Different interventions might be used to diagnose or treat pyelonephritis. Flexible ureteroscopy is done for the treatment of obstructive pyelonephritis. Double J stenting, also known as DJ Stenting, is a conservative management method for emphysematous pyelonephritis. Percutaneous nephrostomy is an effective treatment option for emphysematous pyelonephritis which is characterized by necrotizing damage to the parenchyma of the kidney and its adjoining tissue leading to gas formation. Percutaneous nephrolithotomy or transperitoneal laparoscopic ureterolithotomy (TLU) are effective surgical treatment options for pyelonephritis.
Name of Intervention
Different interventions might be used to diagnose or treat pyelonephritis.
Ureteroscopy
Flexible ureteroscopy is done for the treatment of obstructive pyelonephritis. It is very effective in removing large proximal placed ureteral stones that are greater than 1.5cm. It can be performed after drainage of an infected kidney to effectively remove renal stones. Flexible ureteroscopy has a stone free rate of almost 80%. It has advantages over Transperitoneal laparoscopic ureterolithotomy in that:[1]
- It causes less post operative pain
- Has a lesser hospital stay
- Early return to daily routine
Double J Stenting
Double J stenting, also known as DJ Stenting, is a conservative management method for emphysematous pyelonephritis. A nephrostomy tube or DJ stent can be used to decompress the urinary tract which may be enlarged secondary to various reasons like a tumor or an obstructing stone.[2][3]
Percutaneous nephrostomy
Percutaneous nephrostomy is an effective treatment option for emphysematous pyelonephritis which is characterized by necrotizing damage to the parenchyma of the kidney and its adjoining tissue leading to gas formation. Percutaneous nephrostomy should be accompanied by adequate hydration and glycemic control.[2]
Nephrolithotomy/Ureterolithotomy
Percutaneous nephrolithotomy or transperitoneal laparoscopic ureterolithotomy (TLU) are effective surgical treatment options for pyelonephritis. TLU is effective in removing large ureteral stones with a very high stone free rate approaching upto 100%.[1]
References
- ↑ 1.0 1.1 Sahin S, Resorlu B, Eksi M, Aras B, Atar A, Tugcu V (2016). "Flexible ureteroscopy versus laparoscopy for the treatment of patients who initially presented with obstructive pyelonephritis". Pak J Med Sci. 32 (3): 570–4. doi:10.12669/pjms.323.9938. PMC 4928400. PMID 27375691.
- ↑ 2.0 2.1 Das D, Pal DK (2016). "Double J stenting: A rewarding option in the management of emphysematous pyelonephritis". Urol Ann. 8 (3): 261–4. doi:10.4103/0974-7796.184881. PMC 4944615. PMID 27453644.
- ↑ Meir DB, Inoue M, Gur U, Livne PM, Yaniv Y, Tiedeman K; et al. (2004). "Urinary diversion in children with pelvic tumors". J Pediatr Surg. 39 (12): 1787–90. PMID 15616930.