EVALUATION OF KIDNEY DRAINAGE OF THE IN ACUTE OBSTRUCTIVE PYELONEPHRITIS

Introduction. Currently, there are no generally recognized indications for the choice of methods of drainage of the upper urinary tract in obstructive uropathy. Both external and internal drainage involve a number of shortcomings affecting the quality of life of the patient.

Purpose of research. To evaluate the effectiveness of internal stenting (IC) and puncture nephrostomy (PN) as a method of temporary drainage of the upper urinary tract in acute obstructive pyelonephritis.

Materials and methods. During 2012-2017 we observed 156 patients of both sexes aged from 25 to 74 years with the clinic of acute obstructive pyelonephritis against the background of urolithiasis. To restore the passage of urine is made stenting jj-stent or puncture nephrostomy. Materials and methods. During 2012-2017, we observed 156 patients of both sexes aged 25 to 74 years with a clinical picture of acute obstructive pyelonephritis on the background of urolithiasis. To restore the passage of urine is made stenting jj-stent or puncture nephrostomy.

Results. Clinically, fever in the PN group was stopped for 1.8±0.5 days, and in the IC group this indicator was 5.5±2.8. In the IC group, 18 (58.1%) patients complained of irritative symptoms of varying severity, and in 9 (29.0%) patients pain syndrome in the lower back associated with myction was noted. No similar complications were observed in the PN group. The inability to install and inadequate function of the IC group in 45.5% of cases required conversion in the PN group. The need for revision of the kidney after the PN group was noted in 0.8% of cases (p<0.01).

Conclusion. Subject to adequate techniques of puncture of the kidney and the combined (ultrasonic and radiographic) control the conduct of puncture nephrostomy is a safe method of drainage of the kidney in acute obstructive pyelonephritis, ensuring laying of drainage is of adequate diameter that allows you to get the best results for the relief of pyelonephritis in comparison with the inner stent.

1. Doronchuk DN, Trapeznikova MF, Dutov VV. Choice of an upper urinary tract drainage method in urolithiasis. Urology. 2010;3:7-10. (in Russ.)

2. Auge BK, Sarvis JA, L’Esperance JO, Preminger G. Practice paƩ erns of ureteral stenting atier routine ureteroscopic stone surgery: A survey of practicing urologists. J. Endourol. 2007;21(11):1287-1291. doi: 10.1089/ end.2007.0038

3. Preminger GM, Tiselius HG, Assimos DG et al. EAU/AUA Nephrolithiasis Guideline Panel. 2007.

4. Alyaev YuG, Rapoport LM, Tsarichenko DG, Stoylov SV, Bushuev VО. Stenng of kidneys with ureterohydronephrosis in patients with large prostate hyperplasia. Andrology and genital surgery. 2008;3:43-44. (in Russ.)

5. Trapeznikova MF, Dutov VV, Bazaev VV, Doronchuk DN. To the question of the necessity of the upper urinary tract stenting atier uncomplicated contact ureterolithotripsy. Materials of the First Russian Congress on Endourology (Moscow, June 4-6, 2008). M., 2008:257-258. (in Russ.)

6. Alyaev YG, Rudenko VI, Gazimiev MA. Et al. Types of stenting of the ureter atier contact ureterolithotripsy. Materials of the First Russian Congress on Endourology (Moscow, June 4-6, 2008). M., 2008:126-127. (in Russ.)

7. Chew BH, Knudsen BE, NoƩ L, Pautler SE, Razvi H, Amann J, Denstedt JD. Pilot study of ureteral movement in stented patients: First step in understanding dynamic ureteral anatomy to improve stent discomfort. J. Endourol. 2007;21(9):1069-1075. doi: 10.1089/end.2006.0252

8. Guliyev B.G. Reconstructive surgery with organic obstruction of the upper urinary tract: Dis .... Dr. med. sciences. - St. Petersburg, 2008. (in Russ.)

9. Kogan MI, Shkodkin SV, Idashkin YuB, Lyubushkin AV, Miroshnichenko OV. Evaluation of kidney drainage different methods. Medical bulletin of Bashkortostan. 2013;2:82-85. (in Russ.)

10. Novikova EG, Teplov AA, Smirnova SV, Onopko VF, Rusakov I.G. Structures of ureters in patients with cervical cancer. Russian oncology journal. 2009;3:28-34. (in Russ.)

11. Mudraya I.S. Functional conditions of the upper urinary tract with urological diseases: Dis .... Dr. med. sciences. - M., 2002. (in Russ.)

12. Chepurov AK, Zenkov SS, Mamaev IE, Pronkin EA. Eff ect of prolonged drainage of the upper urinary tract by ureteral stents on the functional abilities of the kidney. Andrology and genital surgery. 2009;172-1721. (in Russ.)

13. Doronchuk DN, Trapeznikova MF, Dutov VV. Assessment of the quality of life of patients with urolithiasis, depending on the method of drainage of the upper urinary tract. Urology. 2010;2:14. (in Russ.)

14. Chepurov AK, Zenkov SS, Mamaev IE, Pronkin EA The role of infection of the upper urinary tract in patients with long drainage of ureteral stents. Andrology and genital surgery. 2009; 173-173. (in Russ.)