Evolutionary profile of pyonephrosis after surgical treatment, about 23 cases

Abstract

ObjectivesTo describe the evolving profile of pyonephrosis after surgical treatment, identifying their epidemiological, clinical, paraclinical, and therapeutic aspects. Materials and methodsDescriptive retrospective study spread over a period of 5 years (2015–2019) including patients with pyonephrosis in the urology department. Results23 cases of pyonephrosis were collected. The average age of patients was 49 years (27–71 years), with male predominance (69.56%). It was found that the main element of the patient's medical history was urolithiasis (57%). Lower back pain is the main sign found in (96%) of cases, followed by infectious agents found in (42%) and a large kidney (21%). Renal ultrasound allowed us to evoke the diagnosis in 41% of cases and urine CT scan confirmed diagnosis in the majority of cases. The etiology was lithiasis in 78.26% of cases. Cytobacteriological urine examination (CEBU) isolated germs in 15 patients (65.21%) predominance of Escherichia coli in 7 cases (30.43%). The treatment included a nephrectomy preceded by a Subcutaneous nephrovesical bypass in 21 patients. The outcome was reassuring in 70.7% of cases, the main complications were parietal suppuration (30.43%), followed by chronic kidney failure (8.69%), enteroenteric fistula (4.34%), and digestive fistula (4.34%). The mortality was (8.69%). ConclusionPyonephrosis is a condition that is becoming increasingly rare. The reduction of its incidence may be related to recent advances in medical imaging which allow early diagnosis of causative conditions and their treatment.