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Pyonephrosis is a condition in which the excess urine in the renal pelvis becomes infected and, due to the lack of effect of antibacterial treatment, begins to resemble purulent contents. The symptoms of this infection include increased pain and refractory feverish septic conditions. Pyonephrosis most often occurs in immunocompromised patients (gks, chemotherapy, HIV +), in patients with diabetes mellitus or recurrent urinary tract infections due to untreated kidney stones.
Oilseeds – characteristics
Pyonephrosis is a complication of hydronephrosis – that is, ailments during which the excessively accumulated urine in the renal pelvis becomes infected and transforms into purulent contents. This is called ascending infection that begins in the lower urinary tract, such as the bladder, and “ascends” to the kidneys. Pyonephrosis can appear due to improper antibacterial treatment. Infection manifests itself primarily with a greater intensity of pain than in hydronephrosis and fever septic conditions that are usually resistant to bactericidal treatment. It can occur in patients with nephrolithiasis or ureteral stones, and in some patients it can be a postoperative complication. Lesions in the urine may contain an increased number of white blood cells and bacteria in the sediment.
Pyonephrosis and hydronephrosis
The element that distinguishes pyonephrosis from hydronephrosis is the presence of inflammation in the area of the renal parenchyma in the case of pyonephrosis. Such a situation may even cause complete destruction of this organ. In contrast, hydronephrosis develops the expansion of the renal pelvis and calyces, and the atrophy of the renal tissue, which in turn causes pressure on the urine remaining in the kidney. The urine remains, for example due to inflammation, and when it is infected, the renal pelvis and calyx are filled with pus.
The causes of pyonephrosis
Pyonephrosis can be caused by the following factors:
- diabetes,
- choroba AIDS,
- the use of certain preparations, e.g. steroids,
- the presence of kidney stones or tumors
- weakened immune system,
- long-term use of antibiotics (high risk of fungal infections). The mycelium is located in the ureter or renal pelvis and can effectively block urine flow and thus pyonephrosis. This ailment occurs at any age (less common in children).
Symptoms of pyonephrosis
We can broadly divide the development of oilseeds into two parts:
- infection – caused by various bacteria, including: streptococci, E.coli, tuberculosis or fungal infections;
- obstruction – it is usually a consequence of the presence of stones, neoplastic metastases, pregnancy or other kidney ailments.
Pyonephrosis is characterized by the following symptoms:
- general weakness
- bad mood,
- lack of appetite
- high temperature,
- enlarged kidney
- pain from weak to very intense,
- discharge from the open ureter,
- inactive kidney with disease – visualized on ultrasound examination after the application of a contrast agent.
Diagnosis of pyonephrosis
Pyonephrosis diagnostics is based mainly on ultrasound examination and computed tomography. In addition, blood and urine tests are performed. Laboratory tests of urine show more white blood cells and bacteria in the urine sediment. The above-mentioned symptoms are also important.
Pyonephrosis – treatment
Roponephrosis is usually an indication for surgical treatment with simultaneous intensive cover of the surgical procedure with antibacterial drugs. Usually, a percutaneous nephrostomy or the insertion of a suitable catheter into the renal pelvis is performed. The mainstay of treatment is intravenous antibiotic therapy. Failure to treat pyonephrosis may result in systemic septic infection and abscesses in the kidney, liver, brain and lungs.
There are two types of surgical treatment:
- stent surgery – a thin tube is placed in the ureter to restore patency. This method is recommended for patients who do not have problems with blood flow;
- bypassing obstruction – this procedure is performed under general anesthesia and is recommended for all patients. If the obstruction is due to the presence of a stone, ureteroscopy, endoscopy or lithotripsy are used to remove it.
How to prevent
Prevention of pyonephrosis is an effective prevention of urolithiasis and urinary tract infections as well as the early treatment of hydronephrosis.