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Clin Exp Nephrol 2020 Jun 26. Epub 2020 Jun 26.

Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

We report a 71-year-old woman who presented with unilateral flank pain and sepsis. A computed tomographic (CT) scan demonstrated left-sided hydronephrosis. Subsequent percutaneous nephrotomy drainage showed pus-like material, confirming the diagnosis of pyonephrosis. Read More

Saudi J Med Med Sci 2020 May-Aug;8(2):156-159. Epub 2020 Apr 17.

Department of Urology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

Pyonephrosis is a rare condition in both adult and pediatric population. Here, the author presents a rare case of pyonephrosis induced by extended-spectrum beta-lactamase-producing in a 12-month-old girl presenting with a picture of urosepsis. The patient presented with febrile urinary tract infection and was unresponsive to intravenous meropenem. Read More

Cardiovasc Intervent Radiol 2020 May 27. Epub 2020 May 27.

Department of Radiology, University Medical Centre, Children's Hospital Ljubljana, Bohoričeva 20, 1000, Ljubljana, Slovenia.

Purpose: The purpose of this study was to evaluate the indications, technique for percutaneous nephrostomy (PCN) insertion, the complications related to PCN, duration of PCN, and outcome following PCN removal regarding the kidney function.

Material And Methods: Medical charts of 31 neonates (22 boys and 9 girls, mean age 13.9 days) treated with 43 PCN were reviewed. Read More

Transl Androl Urol 2020 Apr;9(2):856-862

Wake Forest University Baptist Medical Center, 1 Medical Center BLVD, Winston-Salem, NC 27157, USA.

Background: Management of the distal ureter in radical nephroureterectomy and bladder cuff excision (RNUBCE) is paramount, directly influencing oncologic outcomes. Herein, we analyze the natural history of patients who have undergone robotic radical nephroureterectomy without formal bladder cuff excision and retained ureteral stump and compare this cohort with patients undergoing formal RNUBCE for high-risk upper tract urothelial carcinoma (UTUC).

Methods: From February 2008 to October 2018, all patients who underwent robotic RNUBCE by multiple surgeons in a single institution for high-risk UTUC were reviewed. Read More

Transl Androl Urol 2020 Apr;9(2):781-788

Department of Urology, Xiangya Hospital, Central South University, Changsha 410008, China.

Primary mucinous adenocarcinoma of the renal pelvis is a rare malignant disease that is difficult to diagnose preoperatively. There are still no characteristic symptoms, radiological features, or standard treatment for this tumor with only ~100 cases reported. The prognosis is poor. Read More

Urol Case Rep 2020 Sep 22;32:101218. Epub 2020 Apr 22.

Department of Urology, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK.

Ureteric calculi are a common cause of emergency presentation to hospitals in the United Kingdom and worldwide. A significant and life threatening complication of those stones that obstruct the ureter is pyonephrosis, bacteraemia and resulting sepsis. Whilst the majority of such cases present with the typical symptoms of loin pain and fever, here we describe the case of a 57 year old patient with asymptomatic bilateral obstructing ureteric calculi that led to bacteraemia from a rare bacterial pathogen, Lactobacillus jensenii, and subsequent severe bacterial endocarditis requiring emergency aortic valve replacement. Read More

J Family Med Prim Care 2020 Feb 28;9(2):1263-1265. Epub 2020 Feb 28.

Department of Surgery, AIIMS Bhopal, Madhya Pradesh, India.

Pyonephrosis is an uncommon condition that is associated with suppurative destruction of the renal parenchyma. Upper urinary tract obstruction by renal stones plays an important role in its aetiology. The majority of pyonephrosis is reported to be caused by aerobic bacteria but the role of anaerobes, especially black-pigmented gram-negative anaerobes, namely, Prevotella and Porphyromonas in renal infections, remain poorly defined. Read More

J Am Anim Hosp Assoc 2020 May/Jun;56(3):e56303. Epub 2020 Mar 17.

From the Veterinary Teaching Hospital (X.M.) and Department of Clinical Sciences (M.D., M.F.), College of Veterinary Medicine, University of Montreal, Montreal, Québec, Canada.

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Semin Intervent Radiol 2020 Mar 4;37(1):74-84. Epub 2020 Mar 4.

Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois.

Pyonephrosis is gross accumulation of pus within an obstructed renal collecting system that, if left untreated, can lead to potentially fatal septic shock. Treatment requires urgent decompression coupled with systemic antibiotics. Percutaneous nephrostomy (PCN) placement, first described in 1976 for the treatment of pyonephrosis, is now widely utilized for emergent decompression in these patients. Read More

Curr Med Mycol 2019 ;5(4):54-57

Department of Microbiology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Vibhuti Khand, Gomti Nagar, Lucknow, India.

Background And Purpose: Fungal renal abscesses are rare entities associated with significant morbidity and mortality. Affected kidneys can have microabscess, pyelonephritis, pyonephrosis, or papillary necrosis.

Case Report: Herein, we reported an unusual case of a large renal abscess cause by in a diabetic patient. Read More

J Laparoendosc Adv Surg Tech A 2020 May 6;30(5):520-524. Epub 2020 Feb 6.

Department of Urology, Guizhou Provincial People's Hospital, Guiyang, Guizhou, P.R. China.

To investigate the feasibility of retroperitoneal laparoscopic ipsilateral nephrectomy of a benign nonfunctional kidney after percutaneous nephrostomy, and to compare this method with open surgery. Data from 70 patients who underwent simple nephrectomy from January 2014 to October 2018 at three large centers were retrospectively analyzed. All patients underwent percutaneous nephrostomy because of renal or ureteral calculi with severe hydronephrosis or pyonephrosis. Read More

J Xray Sci Technol 2020 ;28(1):125-135

Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

PURPOSETo evaluate therapeutic efficacy of two minimally invasive surgical methods in managing acute ureteral obstruction and severe infection caused by upper urinary tract calculi (UUTC).PATIENTS AND METHODSData of 47 patients diagnosed with acute upper urinary tract obstruction and severe infection caused by ureteral calculus using X-ray CT between September 2014 and January 2019 were retrospectively analyzed. All patients were treated with immediate renal drainage and, after infection and ureteral obstruction were relieved, UUTC removal. Read More

J Pediatr Hematol Oncol 2019 Nov 1. Epub 2019 Nov 1.

Department of Pediatric Oncology.

Wilms' tumor (WT) is the most common renal malignancy in children. Its clinical and radiologic presentation may mimic other pediatric renal diseases, including pyonephrosis or renal abscess. The authors report a case of a 3-year-old girl presenting with pyelonephritis and right renal mass suggestive of a renal abscess, not responding to antibiotics. Read More

Case Rep Urol 2019 22;2019:4198275. Epub 2019 Sep 22.

Department of Urology, Military Hospital of First Instruction of Tunis, Tunisia.

A 50-year-old man with no past medical history presented with 5 months history of right flank discomfort. Physical examination was unremarkable. CT-scan showed a large right renal pelvic calculi and upper pole hydronephrosis. Read More

J Laparoendosc Adv Surg Tech A 2019 Dec 29;29(12):1565-1570. Epub 2019 Oct 29.

Department of Urology, Faculty of Medicine, Ordu University, Ordu, Turkey.

Percutaneous nephrostomy (PN), the indispensable interventional procedure in situations such as obstructive uropathy and pyonephrosis, requires serious experience. As a result, many urologists and radiologists avoid this procedure. However, this can leave both doctor and patient in a difficult situation when it is necessary. Read More

Zhonghua Yi Xue Za Zhi 2019 Oct;99(38):3005-3007

Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, 200240 China.

To investigate the therapeutic effects of first phase renal puncture and drainage guided by B ultrasound and second phase percutaneous nephrolithotomy(PCNL) in the treatment of urinary calculi complicated with pyonephrosis. From January 2014 to April 2018, 28 patients with upper ureteral segment and kidney calculi complicated with pyonephrosis were collected. All patients received the pyonephrosis puncture under B ultrasound. Read More

Int Urol Nephrol 2020 Jan 20;52(1):9-14. Epub 2019 Sep 20.

Department of Urology, HSU Izmir Bozyaka Training and Research Hospital, Saim Cikrikci Str. No. 59, Bozyaka, Izmir, Turkey.

Purpose: To evaluate the predictive value of attenuation value (HU) in renal pelvis urine for detecting renal pelvis urine culture (RPUC) positivity in obstructed urinary systems.

Methods: The study group consisted of patients who had nephrostomy insertion performed because of obstructed system and suspicion of pyonephrosis and percutaneous nephrolithotomy (PCNL) patients who had obstructed calculi. Group 1 consisted of RPUC positive 28 patients during nephrostomy insertion or needle access in PCNL and group 2 consisted of 23 patients with negative RPUC. Read More

Rev Esp Quimioter 2019 Oct 12;32(5):469-472. Epub 2019 Sep 12.

José Gutiérrez-Fernández. Servicio de Microbiología. Hospital Universitario Virgen de las Nieves. Avenida de las Fuerzas Armadas, 2. E-18012 Granada, Spain.

Aktuelle Urol 2019 Jul 23;50(3):318-323. Epub 2019 Jul 23.

Urolithiasis 2020 Jun 19;48(3):251-256. Epub 2019 Jul 19.

Department of Urology, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China.

There is controversy regarding the predicting value of preoperative urine culture for post-percutaneous nephrolithotripsy (PCNL) infection. The purpose of our study was to re-evaluate the importance of preoperative urine culture for developing post-PCNL systemic inflammatory response syndrome (SIRS) in China. A total of 303 patients undergone PCNL from March 2012 to January 2018 were recruited. Read More

Urol Case Rep 2019 Sep 31;26:100928. Epub 2019 May 31.

Aga Khan University Hospital, Karachi, Pakistan.

Forniceal rupture after pyonephrosis can lead to retroperitoneal abscess but extension into peritoneal cavity is unusual. We present a case of 50 year old lady who presented with acute abdomen, CT scan of abdomen showed features suggestive of left pyelonephritis and large intraperitoneal collection. Laparotomy was planned on suspicion of intraperitoneal source of sepsis. Read More

BMJ Case Rep 2019 May 24;12(5). Epub 2019 May 24.

Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.

Percutaneous nephrostomy (PCN) catheter placement is a commonly performed procedure in the urological practice for various indications like percutaneous nephrolithotomy, pyonephrosis, infected hydronephrosis and after failed attempt of ureteric stenting. The nephrostomy catheter is usually associated with low complication and morbidity rate, but prolonged indwelling nephrostomy tube may be hazardous in some cases. We hereby report a case of squamous cell carcinoma of skin around the PCN, which was attributed to chronic inflammation and persistent irritation from a long-term neglected indwelling nephrostomy catheter for last 3 years. Read More

BMC Anesthesiol 2019 05 1;19(1):61. Epub 2019 May 1.

Department of Anesthesiology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.

Background: Urosepsis is a catastrophic complication, which can easily develop into septic shock and lead to death if not diagnosed early and effectively treated in time. However, there is a lack of evidence on the risk factors and outcomes in calculous pyonephrosis patients. Therefore, this study was conducted to identify risk factors and outcomes of intra- and postoperative urosepsis in this particular population. Read More

J Cancer Res Ther 2019 Mar;15(Supplement):S159-S162

Department of Surgery, Maulana Azad Medical College, New Delhi, India.

Incidentally, detected upper urinary tract urothelial carcinoma is a rare entity. We report the case of a 70-year-old female patient who presented with flank pain, pyuria, fever, and a unilateral nonfunctioning kidney with nephrolithiasis and pyonephrosis on pyelography. Routine imaging failed to identify a mass lesion. Read More

J Tehran Heart Cent 2018 Jul;13(3):132-135

Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Inferior vena cava (IVC) thrombosis is a rare medical condition. Suppurative thrombophlebitis of the IVC is even a more uncommon subtype of IVC thrombosis and is mostly associated with IVC filters or venous catheters. We describe a 66-year-old man with persistent fever and history of pyonephrosis secondary to transurethral lithotripsy 1 month before recent admission. Read More

J Infect Chemother 2019 May 25;25(5):368-370. Epub 2019 Jan 25.

Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo 157-8535, Japan; Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, Memphis, TN, USA. Electronic address:

The significance of anaerobic bacteria as a pathogen in urinary tract infection (UTI) in children is unclear. A two-month-old infant presenting with poor feeding received a diagnosis of polymicrobial anaerobic UTI by next-generation sequencing and was found to have obstructive uropathy. Anaerobic bacteria may be a cause of UTI in children with urinary tract obstruction. Read More

Endoscopy 2019 03 11;51(3):E55-E56. Epub 2019 Jan 11.

Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.

Magn Reson Imaging Clin N Am 2019 Feb 29;27(1):59-75. Epub 2018 Oct 29.

Department of Radiology, Hospital Garcia de Orta, Av. Torrado da Silva, 2805-267 Almada, Portugal; Department of Radiology, Hospital da Luz, Estrada Nacional 10, km 37, Setúbal 2900-722, Portugal. Electronic address:

Urinary tract infection (UTI) is among the most common of bacterial infections. Imaging studies are only required in cases of complicated UTIs. Ultrasound remains the first-line imaging method; however, CT is the gold standard for evaluation of UTIs. Read More

Tunis Med 2018 Aug - Sep;96(8-9):495-500

Introduction: Xanthogranulomatous pyelonephritis (XGPN) is a particular form of chronic renal suppuration characterized by the destruction of renal parenchyma and its replacement by a granulomatous tissue containing xanthomatous cells.

Objective: To report and describe the main clinical, biological, radiological and therapeutic aspects of xanthogranulomatous pyelonephritis in adults in focal and diffuse forms.

Methods: This was a monocentric retrospective study involving 42 cases of XGPN operated and histologically confirmed between 2005 and 2015. Read More

J Am Vet Med Assoc 2018 Nov;253(10):1309-1327

OBJECTIVE To determine outcomes of subcutaneous ureteral bypass (SUB) device placement for treatment of benign ureteral obstruction in cats. DESIGN Retrospective case series. ANIMALS 134 cats with SUB devices placed in 174 obstructed ureters during 144 hospitalizations. Read More

Urol Case Rep 2018 Nov 30;21:36-37. Epub 2018 Aug 30.

SUNY Upstate Medical University, 750 East Adams St. Syracuse, New York, 13210, USA.

BMJ Case Rep 2018 Jul 11;2018. Epub 2018 Jul 11.

Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh, India.

Patients with ectopic kidney require special considerations in their management due to the anatomic characteristics predisposing the kidney to obstruction and related complications. Pelvic ectopic kidneys have the added disadvantage of being confined in the bony pelvis giving less manoeuvrability during surgery of that unit. Vesicovaginal fistulas are usually managed surgically and careful surgical dissection has to be carried out because the highest success rates are usually seen at the first operation. Read More

Clin Case Rep 2018 Jun 6;6(6):1176-1178. Epub 2018 Apr 6.

Division of Nephrology, Hypertension and Renal Transplantation University of Florida Gainesville Florida.

Pyonephrosis is a rare purulent infection of the upper urinary tract, which can lead to rapid clinical deterioration. While contrast-enhanced CT scan is a sensitive test, point-of-care renal sonography can serve as a quick and valuable bedside tool for diagnosis, especially when iodinated contrast use is contraindicated. Read More

Int Med Case Rep J 2018 15;11:113-116. Epub 2018 May 15.

Department of Surgery, School of Medicine, Madda Walabu University, Bale Goba, Ethiopia.

Background: Peritoneal fistulization of a pyonephrosis is an extremely rare event which invariably leads to generalized peritonitis. This is a very rare case report on generalized peritonitis after spontaneous rupture of pyonephrosis.

Case Presentation: A 28-year-old male patient from the rural part of Bale zone, Ethiopia, was admitted to Goba Referral Hospital with high-grade fever, diffused abdominal pain and abdominal distension. Read More

Zhonghua Wai Ke Za Zhi 2018 May;56(5):386-390

Department of Urology, People's Hospital of Lishui City, Lishui 323000, Zhejiang Province, China.

To investigate the necessity of artificial kidney seeper which made through inserting a ureteral tube in the ureter to the ultrasonography-guided percutaneous nephrolithotomy (PCNL). This was a randomized prospective study. Patients who conformed to the inclusion and exclusion criteria were enrolled at Department of Urology, Frist Affiliated Hospital of Wenzhou Medical University from January 2016 to May 2017. Read More

Pol Merkur Lekarski 2018 Apr;44(262):196-200

Department of Pediatrics and Nephrology, Medical University of Warsaw.

Pyonephrosis in the course of hydronephrosis usually provides to total or near-total loss of renal function. In adults pyonephrosis usually results from urolithiasis. In children usually congenital urinary tract anomalies are present as contributing factors. Read More

J Emerg Med 2018 07 9;55(1):e1-e4. Epub 2018 May 9.

Department of Emergency Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.

Background: Febrile urinary tract infections (UTIs) include a spectrum of pathologies from uncomplicated pyelonephritis to urosepsis, including xanthogranulomatous pyelonephritis (XGP). Most febrile UTIs are treated with antibiotics alone, but studies indicate nearly 12% of cases of presumed simple pyelonephritis require emergent urologic intervention. How to identify these individuals, while limiting unnecessary advanced imaging and delays in diagnosis, challenges all emergency providers. Read More

Urol Ann 2018 Apr-Jun;10(2):191-197

Department of Anesthesia, PGIMER, Dr. RML Hospital, New Delhi, India.

Introduction: Urologists tend to prefer retroperitoneal approach for open nephrectomy and transperitoneal route for laparoscopic nephrectomy. Urologists consider retroperitoneal laparoscopic approach difficult to learn and perform. There is a need to objectively define predictors of difficulty during laparoscopic retroperitoneal simple nephrectomy (LRSN) for the proper preoperative selection. Read More

Ir J Med Sci 2019 Feb 26;188(1):283-288. Epub 2018 Apr 26.

Department of Interventional Radiology, University Hospital Waterford, Ardkeen, Waterford, Ireland.

Introduction: To assess the benefits and complications of developing a practice of single-stage primary ureteral stenting in a university hospital.

Methods: A practice change developed from the traditional practice of multi-stage stenting to single-episode stent placement. To evaluate this change of practice, we retrospectively analysed data of 70 patients who underwent primary tubeless antegrade ureteric stenting and compared this group to the previous 54 patients who had a covering nephrostomy. Read More

J Endourol Case Rep 2018 1;4(1):39-41. Epub 2018 Mar 1.

Department of Urology, UCSF Medical Center, San Francisco, California.

Laparoscopic heminephrectomy was performed in a 64-year-old woman with a chronically obstructed horseshoe kidney moiety. More than 3000 cc of pyonephrosis was drained through two percutaneous nephrostomy tubes for infection control before left moiety laparoscopic resection. This case report attests to the feasibility of laparoscopic resection of a massively obstructed horseshoe kidney when performed in a staged manner after prolonged drainage. Read More

Pediatr Nephrol 2018 11 12;33(11):2081-2083. Epub 2018 Apr 12.

Department of Anaesthesia, All India Institute of Medical Sciences, Rishikesh, India.

Urol Case Rep 2018 May 2;18:41-43. Epub 2018 Mar 2.

Albert Einstein College of Medicine, Montefiore Medical Center, Department of Urology, Bronx, NY, 10467, United States.

Emerg Radiol 2018 Aug 13;25(4):381-386. Epub 2018 Mar 13.

Department of Diagnostic Imaging, Monash Health, Melbourne, VIC, Australia.

Purpose: To investigate if the presence of systemic inflammatory response syndrome (SIRS) in patients with urinary tract obstruction at time of presentation to the emergency department correlates with a subsequent positive urine culture and to determine if it could be used as a tool to predict the urgency of a percutaneous nephrostomy (PCN). The secondary aim of the study was to assess the incidence of in-hour and after-hour emergent PCNs performed in a tertiary center which has both interventional radiological and urological expertise.

Methods And Materials: Emergent adult PCN cases referred from the emergency department between 2011 and 2016 were identified retrospectively. Read More

J Am Vet Med Assoc 2018 Mar;252(6):744-753

CASE DESCRIPTION 4 cats were examined because of ureteral obstruction. CLINICAL FINDINGS Clinical and clinicopathologic abnormalities were nonspecific and included anorexia, lethargy, weight loss, anemia, leukocytosis, neutrophilia, lymphopenia, and azotemia. A diagnosis of pyonephrosis was made in all cats. Read More

Med Clin (Barc) 2018 11 28;151(10):419-420. Epub 2018 Feb 28.

Servicio de Medicina Interna, Hospital clínico Universitario de Valladolid, Valladolid, España.

Hinyokika Kiyo 2017 Dec;63(12):529-532

The Department of Urology, Fujita Health University.

A 47-year-old woman who was diagnosed with right pyelonephritis by a local physician, but failed to respond to antimicrobial chemotherapy, was referred to our hospital. Here, the diagnosis of right pyonephrosis was confirmed byabdominal computed tomography(CT). Retrograde pyelography(RP) revealed a severe stricture at the ureteropelvic junction, and it was considered difficult to advance a guidewire through the stricture. Read More

Tech Vasc Interv Radiol 2017 Dec 9;20(4):288-293. Epub 2017 Oct 9.

Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA.

Biliary and urinary obstructions can be managed endoscopically or cystoscopically, surgically or by percutansous intervention or drainage. If the obtructed system is infected, emergent decompression is needed. Early recognition and treatment is paramount in both conditions. Read More