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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Xantogranulomatous pyelonephritis is a rare disease, occuring most frequently in middle-aged woman. The patients usually present with recurrent fever, dysuria, renal colic or aspecific findings. We report a case of focal PXG (paranephric stage) treated with conservative surgery. Generally, treatment consists of nephrectomy for diffuse or advanced stage diseases, excision of the diseased renal segment for localized and low/high stage.
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PMID:[Xanthogranulomatous pyelonephritis: conservative therapy in the para-nephritic stage. Apropos of a case]. 896 53

The purpose of the present study was to evaluate in situ extracorporeal shock wave lithotripsy (ESWL) for the treatment of obstructing ureteral stones causing acute renal colic. In situ ESWL with an EDAP LT-02 piezo-electric lithotriptor was used in a prospective study to treat 67 patients with obstructing ureteral stones causing acute renal colic. Patients were treated without anesthesia on an out-patient basis or during a one-day hospital stay. The overall one month stone-free rate was 94% (94% for proximal stones and 95% for distal stones). The overall success rate after a single ESWL session was 81%. Treatment was well tolerated in 90% (60/67) of patients. There was one case of non-obstructive pyelonephritis and one of ureteral edema. These rates compare well with published reports for delayed treatment in patients without renal colic. Immediate ESWL for cases of acute renal colic due to obstructing ureteral stones is an effective treatment strategy that warrants wider consideration.
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PMID:In situ extracorporeal shock wave lithotripsy for acute renal colic due to obstructing ureteral stones. 916 75

The aim of our study was to assess the diagnostic yield of intravenous urography (IVU) compared to ultrasound (US) and computerized tomography (CT) in cases of renal colic, suspected pelvic and abdominal malignancies, suspected renal mass, and acute pyelonephritis. We retrospectively analyzed the case charts of 216 consecutive patients. The patients had been referred to the Department of Radiology by different hospital departments and local general practitioners. All had undergone clinical examination, US and IVU, in that order. When deemed necessary, conventional tomography was performed. Patients with renal masses also underwent CT. In cases without renal colic and normal US examination, the subsequent IVU failed to detect any further important pathology. Hydronephrosis was equally well detected using US and IVU, however, the level of obstruction was better determined using delayed X-ray films. In 24% of cases of renal colics the initial US was normal, however, the IVU revealed ureteric obstruction. Repeat US 8-12 h later always showed hydronephrosis. In 6 of 34 solid renal masses, IVU and conventional tomography failed to make the correct diagnosis, but never could the patient be spared a subsequent CT. IVU is only indicated if US shows hydronephrosis. In cases of renal colic, repeat US is necessary to diagnose the possibly developing hydronephrosis. Clinical history, US and a plain abdominal image will suffice to make the diagnosis. Renal masses always require CT. In these cases, IVU is not necessary. There is no indication left for conventional renal tomographies.
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PMID:Intravenous urography revisited in the age of ultrasound and computerized tomography: diagnostic yield in cases of renal colic, suspected pelvic and abdominal malignancies, suspected renal mass, and acute pyelonephritis. 925 22

According to various authors the frequency of inflammatory complications associated with the use of IUDs ranges from 2% to 8%. Gynecological surgery on account of purulent, inflammatory disease of the adnexa uteri associated with IUD use (4-7%), damaging the urinary bladder and the ureters, is not uncommon. At the urological clinic of Stavropol, Russia, a total of 64 women who were in the 18-64 year age range, had urological complications, and had worn IUDs for 6 months to 14 years were observed. 34 of them presented with acute pyelonephritis attacks, 29 of them with renal colic and acute pyelonephritis, and 26 with renal calculi. In 22 women the acute pyelonephritis attacks were treated with antibiotics and uro-antiseptics. 19 of the 29 women who had renal colic and acute pyelonephritis underwent catheterization and drainage of the renal pelvis, and all of them passed fine kidney stones after the removal of their catheters. Urethral catheterization and drainage of the renal pelvis were performed in 31 patients in order to arrest renal colic and acute pyelonephritic attacks. The catheters stayed in for 2-3 days. For all these women removal of the IUD was recommended. 1 patient underwent ureterolithotomy. 8 patients rejected the removal of the IUD and had recurrent renal colics and acute pyelonephritis attacks. Removal of the IUD arrested pyelonephritis and lithogenesis in the kidneys. In 1 case of IUD removal injury to the uterine cervix and urinary bladder occurred, resulting in a vesicovaginal fistula. The report concludes with the case of a 44-year old patient who had worn a plastic IUD for 14 years.
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PMID:[The urological complications of contraception using intrauterine coils]. 941 10

Successful disintegration of the calculus in nephrolithiasis patients is impossible without normalization of the upper urinary tracts urodynamics in dyskinesia. We employ combined treatment with high-selective beta-2-adrenomimetic hexoprenalin (hinipral) to improve migration of the concrement fragments and therefore to prevent ureteral occlusion, acute pyelonephritis and renal colic. Hexoprenalin (hinipral) is taken 6 tablets a day or intravenously in drops (5 ml per 100 ml of saline) 3-5 days before and for 10-12 days after extracorporeal shock-wave lithotripsy. Adjuvant use of hexoprenalin in combined treatment of nephrolithiasis complicated by ureteropelvic dysfunction allows effective conduction of lithotripsy.
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PMID:[beta 2-Adrenomimetics before and after extracorporeal lithotripsy]. 982 34

Percussion of the kidney as a diagnostic method was first described by John Benjamin Murphy (1857-1916). The test is rapidly elicited, but can cause severe pain. Considering acute pyelonephritis or acute renal colic, it is common practice to perform fist percussion of the kidney, yet its diagnostic value is unknown. Finnish study results in 1998 suggest that in acute renal colic loin tenderness and erythrocyturia are more significant signs than renal tenderness. There is no scientific evidence for determining renal tenderness in diagnosing urinary tract infections and urolithiasis.
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PMID:[Physical diagnosis--pain elicited by percussion in the kidney area]. 1155 74

The authors report 5 cases of extensive loss of substance of the distal ureter due to radiation fibrosis, operative trauma or tumour invasion; these lesions occurred during the course of a genital tumour in 4 cases and rectal prolapse in one case. The lesion was bilateral and radiation-induced in 2 cases and unilateral in 3 cases. The patients presented with renal colic in 2 cases, renal failure in 1 case and infection in 2 cases (pyelonephritis, septic shock). All patients presented with secondary hydronephrosis. The extent of the lesions made vesical anastomosis impossible, especially as the bladder was irradiated and/or absent in 3 cases. Anastomosis of the proximal ureteric stump onto the contralateral ureter was impossible in the presence of bilateral lesions requiring diversion of the contralateral ureter or due to the short donor ureter, or because of the discordant diameter of the two ureters. Transureteropyelostomy was therefore performed in these 5 cases. The postoperative course was uneventful 4 cases, with a transient anastomotic fistula in only one case. Four of the 5 patients achieved long-term survival with an excellent clinical and radiological result.
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PMID:[Trans-ureteral pyelostomy: 5 cases]. 1129 35

The authors report a rare congenital anomaly, retrocaval ureter (RCU) with carcinoma. The patient had recurrent pyelonephritis, hematuria and renal colic. Urography shows no function on right side. Abdominal ultrasound revealed marked right hydronephrosis. Antegrade ureterography through nephrostomy revealed a RCU. Helical C.T. confirmed the RCU and also revealed a defect in contrast medium in the upper ureter. We performed percutaneus antegrade nephro-ureteroscopy and found carcinoma of the retrocaval ureter. This may be the first case of tumor in the RCU. We did not find any other in the literature. (Fig. 3, Ref. 14.).
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PMID:Retrocaval ureter with ureteral carcinoma. 1505 34

Several conditions can clinically mimic renal colic. We assessed the accuracy of non-contrast-enhanced helical CT and of ultrasonography (US) in offering an alternative explanation for flank pain. In a 3-year period, 181 patients with acute flank pain underwent US and non-contrast-enhanced helical CT in a blinded sequence. Their efficacy in detecting both alternative causes of pain and additional findings unrelated to the pain was assessed in 160 cases with a confirmed diagnosis. An alternative cause was found in 23 cases (14%). US gave 4 false-negative results (1 acute appendicitis, 1 ovarian cyst torsion, 1 diverticulitis, and 1 papillary necrosis) and 2 false-positive results (1 acute pyelonephritis and 1 diverticulitis), with a 78% sensitivity and a 98% specificity for nonlithiasic causes. CT gave 5 false-negative results (1 complicated ovarian cyst, 1 pleuritis, 1 epididymitis, 1 acute pyelonephritis, and 1 papillary necrosis) and 1 false-positive (1 simple ovarian cyst described as a complicated lesion), resulting in a 74% sensitivity and a 99% specificity for diagnosing alternative causes. There were 130 additional US findings in 68 patients and 151 additional CT findings in 77 patients. A wide spectrum of findings can be identified in subjects imaged for flank pain. Non-contrast-enhanced helical CT and US have comparable accuracy in diagnosing causes other than stone disease.
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PMID:Acute flank pain: comparison of unenhanced helical CT and ultrasonography in detecting causes other than ureterolithiasis. 1529 May 74

The many anatomical and physiological changes occurring during pregnancy affect the entire urinary tract. These changes can induce various urological diseases, alter renalfunction and can be life-threatening to the foetus and the mother Some changes can persist post partum. Asymptomatic bacteriuria must be investigated and treated to prevent about 40% of pyelonephritis and a twofold higher premature delivery rate. Duplex ultrasound is the reference examination to diagnose renal colic due to stones and a low-dose IVU can be proposed whenever there is a doubt about the diagnosis. Treatment is conservative. Lower urinary tract symptoms are very frequent and some disorders, such as stress incontinence, can persist after delivery. This review article describes the anatomical and physiological changes observed during pregnancy and their pathological consequences on the urinary tract in order to detect, prevent and treat these disorders.
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PMID:[Urological problems encountered during pregnancy]. 1582 83


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