title: Long-term results after acute therapy of obstructive pyelonephritis.
abstract: BACKGROUND
  To evaluate therapeutic results till 5 years after therapy of obstructive pyelonephritis (OPN) emphasizing regular follow-up.
  
  
  METHODS
  During 5 years, 57 patients with OPN were treated. The patients' charts were reviewed retrospectively for clinical data. These were completed by a questionnaire.
  
  
  RESULTS
  In the group of 57 patients (average age 56 years), about two third were women. Urolithiasis (65%) and tumors (21%) were the main causes of obstruction; fever (91%) and loin pain (86%) the main symptoms. Three fourth of the patients showed renal insufficiency and nearly 50% anemia. E. coli and Proteus spp. were the dominating organisms. Sonography detected obstruction in 93% cases. In one third of cases, CT scan was added; 81% percutaneous nephrostomy and 19% ureteral stenting were the initial methods of urinary drainage. During therapy, 23% nephrectomies (19% complete, 4% partial) were performed. Long-term follow-up showed 11% recurrent OPN and 33% recurrent UTI.
  
  
  CONCLUSIONS
  After diagnosis of OPN, primary nephrostomy or ureteral stenting and antibiotic therapy are the first measures. If recurrent urinary tract infections or OPN occur, long-term follow-up and low-dose antibiotic prophylaxis may be discussed.
authors: Department of Urology Kurpark-Klinik, Bad Nauheim, Germany.
authors: Winfried
authors: W
authors: Vahlensieck
authors: Doris
authors: D
authors: Friess
authors: Werner
authors: W
authors: Fabry
authors: Raphaela
authors: R
authors: Waidelich
authors: Thomas
authors: T
authors: Bschleipfer
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000295:instrumentation; D011704:Pyelonephritis / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D053018:Pyonephrosis / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014547:Urinary Diversion / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D052878:Urolithiasis / Q000150:complications / Q000628:therapy; D014571:Urologic Neoplasms / Q000150:complications / Q000628:therapy; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents