[Treatment strategy for renal abscesses].
OBJECTIVE
A retrospective assessment of treatment results in a group of patients treated for renal abscesses by our work team during the last five years. The aim is to determine the most suitable therapeutical approach for each abscess group, depending on their size.


METHODS
There were 13 patients in the group (10 of them were women and 3 of them were men, aged 36, on average). The ultrasound examination of the kidneys was conducted using the 5 MHz appliance. In cases when antibiotics were prescribed, they were prescribed in combination, most often ampicillin and gentamicin. The evacuation percutaneous punction of the abscess cavity was carried out using a standard technique under the sonographic control. The kidney was approached via lumbotomy during the nephrectomy procedure.


RESULTS
The hospitalization lasted for 19 days on average (5-72 days). The right and left kidney involvement ratio was 5:8. In four cases we chose a conservative approach, in all cases, the patients concerned were treated during the previous three years. The abscess cavity measured 2.75 cm on average, in the above patients cases. Eight patients underwent a percutaneous punction of the abscess cavity. The average size of the renal abscess was 5.5 cm in this patient group. One patient underwent nephrectomy. The patient concerned was immunosuppressed. Three- to four months after the treatment commenced, the control CT scan revealed no residual abscess foci.


CONCLUSIONS
The medium-sized renal abscesses may be solved using a percutaneous abscess punction. The small-sized abscesses may be successfully solved using antibiotics, introduced parenterally. The conservative treatment is considered inappropriate in cases of immunocompromized patients and for abscesses larger than 5 cm.
Pesl
M
M
Urologická klinika VFN a 1. LF UK, Praha.
Zámecník
L
L
Pokuta
P
P
Soukup
V
V
Dvorácek
J
J
D000038:Abscess / Q000175:diagnosis / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D004322:Drainage; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018084:Ultrasonography, Interventional