EFFECTIVENESS OF DRAINAGE FOR ACUTE OBSTRUCTIVE PYELONEPHRITIS SECONDARY TO URETERIC CALCULI

Abstract

Purposes: To evaluate the effectiveness drainage for acute obstructive pyelonephritis secondary to ureteric calculi. Materials and Methods: 45 patients with obstructive pyelonephritis due to urolithiasis were hospitalized between October 2015 and Mars 2018 at Hue University of Medicine and Pharmacy Hospital. Results: The male to female ratio was 1 : 5.5. The median age was 54.16 ± 10.29 years (range 34 – 74 years). The physical findings at the time of hospitalization were as follows: body temperature 38.87 ± 0.66°C, pulse rate 94.38 + 12.29/min, respiratory rate 24.62 ± 5.57/min, systolic blood pressure 120.11 ± 16.39 mmHg, diastolic blood pressure 73.66 ± 9.19 mmHg. The laboratory findings were as follows: WBC: 13.97 ± 5.27g/l, platelets 266.91 ± 139.932 g/l, serum creatinine 96.09 ± 34.023 umol/l, serum CRP 160.08 ± 96.42 mg/l, serum procalcitonin 9.21 ± 22.57 ng/ml. The average size of the stones was 15.89 ± 9.84 mm (5 - 47). 14 patients had a positive urine culture result. The SIRS in 39 patients (86.7%). 44 patients (97.8%) received transurethral stenting using a double-J ureteral catheter and 1 patient (2.2%) received percutaneous nephrostomy. All patients received antimicrobial therapies. After the drainage of the upper urinary tract and antimicrobial therapies, all patients were apyretic. The flank pain and of the costovertebral angle tenderness disappeared. The serum WBC, CRP and Procalcitonin were decreased. Conclusions: Upper urinary tract infection in the patient with obstructive urolithiasis is a urologic emergency. It is necessary to drainage early to avoid septic shock and eventually death. Key words: acute obstructive pyelonephritis secondary, ureteric calculi, septic shock