Methods of Drainage of the Upper Urinary Tract with Obstructive Purulent Pyelonephritis Caused by the Urinary Stone Disease

Abstract

We have analized the result of treatment of 206 patients with the pathology of the upper urinary tract and obstructive pyelonephritis caused by urinary stone disease and infected kidney cysts treated in 2005–2014 at urology department of Lviv. 109 patients with obctruction of the upper urinary tract caused by uri nary stone disease without destruction in renal parenchyma belonged to the first group. There were 62 women and 47 men among the treated patients. The age of male and female patients was 59,5±0,5 and 63,4±1,3. The second group included 106 patients with obctruction of the upper urinary tract caused by urinary stone disease with destruction in renal parenchyma. There were 56 women (52,8%) and 50 men (47,1%). The age of male and female patients was 59,3±0,2 and 56,1±0,3. In 97 patients of the controllable group the process was one sided and in 9 patients the process was bilateral. The pathology process was localized in 54 patients in the right kidney. And in 52 patients in the left. 21 patients with infected kidney cysts belonged to the third group. Among them were 9 men, the rest – women. The average age of men was 57,1±5 and women – 68,3±5. The process was localized in 15 patients of this group in the right kidney, and in 6 patients – in the left kidney. 62,2 per cent of patients with the pathology of the upper urinary tract and obstructive pyelonephritis caused by kidney stones without destruction in renal parenchyma were drained using JJ stent, and 37,7 per cent of patients were treated using percutaneous drainage. In case with ureteral stones in 73,2 per cent of patients were treated using JJ stent, and 26,7 per cent of patients were treated using percuta neous drainage with help of nephrostomy under the ultrasonic control. Nephrostomy was used for 75,6 per cent of patients in case of obstructive pyelonephritis with destruction in renal parenchyma caused by urinary stone disease, for the renewal of the urine passage with the presence of kid ney stones. JJ stent was used for 24,3 per cent in case of urinary stone dis ease with the destruction in renal parenchyma cased by the obstructive pyelonephritis, drainage by JJ stent was used for 62,5 per cent of patients, and nephrostomy was used for 37,5 per cent of patients. The puncture of the hotbeds of the destruction in renal parenchyma was carried out in all the patients of this group together with the drainage of the upper urinary tract. The puncture aspiration of cysts without the drainage of the upper urinary was carried out in all the patients is case of infected kidney cysts.