Pyelonephritis interventions: Difference between revisions
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==Overview== | ==Overview== | ||
Different interventions might be used to diagnose or treat pyelonephritis. A [[biopsy]] can be done to confirm the diagnosis of a complex [[renal]] pathology or to check the extent and type of damage to the [[kidney]]. 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== | ==Name of Intervention== | ||
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*Early return to daily routine | *Early return to daily routine | ||
===Double J Stenting=== | ===Double J Stenting=== | ||
Double J [[stenting]], also known as | 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.<ref name="pmid27453644">{{cite journal| author=Das D, Pal DK| title=Double J stenting: A rewarding option in the management of emphysematous pyelonephritis. | journal=Urol Ann | year= 2016 | volume= 8 | issue= 3 | pages= 261-4 | pmid=27453644 | doi=10.4103/0974-7796.184881 | pmc=4944615 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27453644 }}</ref><ref name="pmid15616930">{{cite journal| author=Meir DB, Inoue M, Gur U, Livne PM, Yaniv Y, Tiedeman K et al.| title=Urinary diversion in children with pelvic tumors. | journal=J Pediatr Surg | year= 2004 | volume= 39 | issue= 12 | pages= 1787-90 | pmid=15616930 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15616930 }}</ref> | ||
===Percutaneous nephrostomy=== | ===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]].<ref name="pmid27453644" /> | [[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]].<ref name="pmid27453644" /> | ||
===Nephrolithotomy/ | ===Nephrolithotomy/Ureterolithotomy=== | ||
[[Percutaneous]] nephrolithotomy or | [[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%.<ref name="pmid27375691" /> | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} |
Revision as of 20:19, 12 June 2018
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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. A biopsy can be done to confirm the diagnosis of a complex renal pathology or to check the extent and type of damage to the kidney. 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.
Renal biopsy
- A biopsy can be done to confirm the diagnosis of a complex renal pathology or to check the extent and type of damage to the kidney.
- It is used specifically in case of xanthogranulomatous pyelonephritis that is confused with renal tumors usually Wilm's tumor.
- The histopathological exam of the biopsy specimen confirm xanthogranulomatous type of 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.