title: Retrograde ureteric stent insertion in the management of infected obstructed kidneys.
abstract: OBJECTIVE
  To quantify the outcomes of retrograde ureteric stenting in the setting of infected hydronephrosis secondary to ureteric calculi.
  
  
  METHODS
  Prospective analysis of all patients over a 15-month period admitted with infected obstructed kidneys secondary to ureteric calculi. Inclusion criteria were based on clinical evidence of systemic inflammatory response syndrome (SIRS) and radiological evidence of obstructing ureteric calculi. Outcome measures included success of procedure, admission to intensive care unit (ICU), length of hospital stay, morbidity, and all-cause mortality during hospital admission.
  
  
  RESULTS
  In all, 52 patients were included. Success of retrograde ureteric stenting was 98%. In all, 17% of patients required an ICU admission, with a post ureteric instrumentation ICU admissions rate of 6%. The mean white cell count and serum creatinine improved significantly after the procedure. Major complication rate included septic shock 6%, but there were no episodes of major haemorrhage and no deaths.
  
  
  CONCLUSIONS
  Retrograde ureteric stenting is safe and effective in infected obstructed kidneys with results comparable to percutaneous nephrostomy tube insertion. Post instrumentation ICU admissions occur in 6% of retrograde stentings.
authors.affiliation: Department of Urological Surgery, Fremantle Hospital, Perth, Australia.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Flukes
authors.forename: Dickon
authors.initials: D
authors.lastname: Hayne
authors.forename: Melvyn
authors.initials: M
authors.lastname: Kuan
authors.forename: Michael
authors.initials: M
authors.lastname: Wallace
authors.forename: Kevin
authors.initials: K
authors.lastname: McMillan
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Rukin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D053018:Pyonephrosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D015607:Stents; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014514:Ureteral Calculi / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014517:Ureteral Obstruction / Q000503:physiopathology / Q000601:surgery*; D055986:Vital Signs; D055815:Young Adult
keywords: calculi; hydronephrosis; infection; sepsis; stents