Pyonephrosis surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Harsh Vardhan Chawla, M.B.B.S.[2]

Surgery

  • Prior to the 1980s, nephrectomy was the standard treatment for pyonephrosis.[1]
  • Presently, interventional procedures are required to drain the pus in pyonephrosis.
  • Drainage of the pus can be done through either retrograde catheterization (placing a catheter in the ureter) or antegrade decompression through percutaneous nephrostomy tube placement
  • Retrograde decompression is a minimally invasive procedure that requires placement of catheter in ureters. It is performed under general anesthesia and is contraindicated in hemodynamically unstable patients. Ureteric stenting is a good option for drainage of pus.[2]
  • Percutaneous nephrostomy catheter placement is done when patient is hemodynamically unstable

References

  1. Fatima R, Jha R, Muthukrishnan J, Gude D, Nath V, Shekhar S; et al. (2013). "Emphysematous pyelonephritis: A single center study". Indian J Nephrol. 23 (2): 119–24. doi:10.4103/0971-4065.109418. PMC 3658289. PMID 23716918.
  2. Chang CW, Huang CN (2020). "Pyonephrosis drained by double-J catheter". Clin Case Rep. 8 (12): 3586–3587. doi:10.1002/ccr3.3204. PMC 7752604 Check |pmc= value (help). PMID 33363990 Check |pmid= value (help).

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