Urolithiasis
Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed in MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Pyonephrosis may be relieved with either a ureteric stent or percutaneous nephrostomy (PCN). One of the advantages of PCN is that it may be inserted under local anaesthesia thereby obviating the need for general anaesthesia in a patient who may be unstable due to sepsis or hyperkalaemia. That said, some clinicians will place stents without a GA, especially in women. Furthermore, a PCN may require less instrumentation of the urinary tract and reduce the risk of exacerbating sepsis. On the other hand, PCN requires the skills of an experienced interventional radiologist and where this expertise is not available a retrograde stent inserted by an experienced urologist may be a better option. The literature to date supports both methods of decompression [19,20].
The urinary tract and male reproductive system
C. Simon Herrington in Muir's Textbook of Pathology, 2020
These comprise acute inflammation of the pelvis, calyces, and renal parenchyma, which, in severe cases, may progress to suppuration and abscess formation. There is purulent urine with congestion and inflammation of the pelvicalyceal mucosa. Pale linear streaks of pus may extend radially from the tip of the papilla to the surface of the cortex where adjacent lesions may fuse to produce abscesses. There may be considerable destruction of the cortex although there tends to be relative sparing of glomeruli and blood vessels. When severe there may be almost total or complete obstruction and pus may accumulate in the pelvises and calyces to produce a pyonephrosis. Extension of this through the renal capsule may produce a perinephric abscess.
Unexplained Fever In Urology
Benedict Isaac, Serge Kernbaum, Michael Burke in Unexplained Fever, 2019
Pyonephrosis refers to the condition in which the pelvis and calyces are filled with pus. The diagnosis of pyonephrosis is suspected when the clinical symptoms of fever anf flank pain are combined with the radiologic evidence of obstruction to the urinary tract. This condition, the result of long-standing obstruction and infection, presents a picture of marked destruction of renal parenchyma, dilated calyces of thin walls, multiple cavities filled with infected exudate, and minimal renal functioning units. The destruction and loss of function are due to the combination of back-pressure and infection.19,55
Fibrin glue as a sealant in stentless laparoscopic pyeloplasty: A randomised controlled trial
Published in Arab Journal of Urology, 2019
Ahmed Farouk, Ahmed Tawfick, Mahmoud Reda, Ahmed M. Saafan, Waleed Mousa, Ahmed M. Tawfeek, Hassan Shaker
Exclusion criteria: Non-secreting kidney with split function of <15%.Previous renal surgery.Pyonephrosis.Children aged <2 years.Bleeding tendency.
Emergency decompression for patients with ureteral stones and SIRS: a prospective randomized clinical study
Published in Annals of Medicine, 2023
Xiaofei Lu, Benzheng Zhou, Dechao Hu, Yanting Ding
Boeri et al. also showed that pyonephrosis can cause a rapid loss of renal function and quickly develop into urosepsis or even septic shock [22]. Thus, emergency decompression is required to protect renal function and prevent urosepsis development in patients with pyonephrosis. In this study, we found that pyonephrosis is a risk factor development of urosepsis after decompression (p < .001).
Influence of postnatal hydroureter in determining the need for voiding cystourethrogram in children with high-grade hydronephrosis
Published in Arab Journal of Urology, 2018
Amr Hodhod, John-Paul Capolicchio, Roman Jednak, Eid El-Sherif, Abd El-Alim El-Doray, Mohamed El-Sherbiny
Concomitant PUJO and VUR are uncommon, with 8–11% of patients diagnosed initially as PUJO [3,19]. In our present study, concomitant PUJO and VUR represented 3.65% of HGH. All our patients who had suspected PUJO and VUR received antibiotic prophylaxis, as refluxing could result in pyonephrosis.
Related Knowledge Centers
- Hydronephrosis
- Kidney Failure
- Nephrostomy
- Nephrotic Syndrome
- Pus
- Pyelonephritis
- Kidney
- Renal Pelvis
- Kidney Stone Disease
- Ureteric Stent