31. Results of emergency treatment of hydronephrosis infection due to ureteral stones at Hanoi Medical University Hospital
Main Article Content
Abstract
The study was conducted on 102 patients diagnosed with infectious hydronephrosis due to ureteral stones with indications for emergency treatment at Hanoi Medical University Hospital from January 2018 to July 2023. The results showed that of 102 patients, 52.9% of patients received percutaneous renal pelvis drainage, 17.6% had a JJ catheter placement and 29.4% had ureteroscopic lithotripsy. After treatment, the proportion of patients with fever was 20.6%, decreased compared to before surgery (54.9%) (p < 0.01). There were no complications of shock during and after surgery or serious complications in the number of patients assigned to endoscopic lithotripsy. Bacteria isolated in urine were mainly E. Coli (57.4%). Average hospital stays: 11.76 ± 7.55 days. Conclusion: Percutaneous pyelonephritis drainage under imaging and JJ catheter placement is safe and effective for infectious hydronephrosis. However, ureteroscopic lithotripsy is indicated in some cases where the patient's overall condition is stable, the renal pelvis is not dilated and there is no pyelonephritis.
Article Details
Keywords
D-J stent, ureteroscopic lithotripsy, infectious hydronephrosis, renal pelvis drainage
References
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21. Stewart A, Joyce A. Modern management of renal colic. Trends in Urology, Gynaecology & Sexual Health. 2008; 13(3): 14-17.
22. Pham PC, Khaing K, Sievers TM, et al. 2017 update on pain management in patients with chronic kidney disease. Clin Kidney J. 2017; 10(5): 688-697.
23. Choong FX, Antypas H, Richter-Dahlfors A. Integrated Pathophysiology of Pyelonephritis. Microbiol Spectr. 2015; 3(5): 503-522.
24. Buonaiuto VA, Marquez I, De Toro I, et al. Clinical and epidemiological features and prognosis of complicated pyelonephritis: a prospective observational single hospital-based study. BMC Infect Dis. 2014; 14: 639.
25. Spoorenberg V, Prins JM, Opmeer BC, de Reijke TM, Hulscher MEJL, Geerlings SE. The additional value of blood cultures in patients with complicated urinary tract infections. Clin Microbiol Infect. 2014; 20(8): 476-479.
26. Tambo M, Okegawa T, Shishido T, Higashihara E, Nutahara K. Predictors of septic shock in obstructive acute pyelonephritis. World J Urol. 2014; 32(3): 803-811.
27. Tambo M, Taguchi S, Nakamura Y, Okegawa T, Fukuhara H. Presepsin and procalcitonin as predictors of sepsis based on the new Sepsis-3 definitions in obstructive acute pyelonephritis. BMC Urol. 2020; 20:23.
28. Xu RY, Liu HW, Liu JL, Dong JH. Procalcitonin and C-reactive protein in urinary tract infection diagnosis. BMC Urol. 2014; 14:45.
29. Nencka P, Zachoval R, Záleský M, et al. C15 Role of procalcitonine in diagnostics of acute pyelonephritis. European Urology Supplements. 2009; 8(8): 662.
2. Hsu CY, Fang HC, Chou KJ, Chen CL, Lee PT, Chung HM. The clinical impact of bacteremia in complicated acute pyelonephritis. Am J Med Sci. 2006; 332(4): 175-180.
3. Brown P, Ki M, Foxman B. Acute pyelonephritis among adults: cost of illness and considerations for the economic evaluation of therapy. Pharmacoeconomics. 2005; 23(11): 1123-1142.
4. Bonkat G., Pickard R., Bartoletti R., Bruyère F., Geerlings S.,, Wagenlehner F., Wullt B.J.E.A.o.U. EAU Guidelines on Urological Infections 2022. Published online 2017: 22-26.
5. Pearle MS, Pierce HL, Miller GL, et al. Optimal method of urgent decompression of the collecting system for obstruction and infection due to ureteral calculi. J Urol. 1998; 160(4): 1260-1264.
6. Wang CJ, Hsu CS, Chen HW, Chang CH, Tsai PC. Percutaneous nephrostomy versus ureteroscopic management of sepsis associated with ureteral stone impaction: a randomized controlled trial. Urolithiasis. 2016; 44(5): 415-419.
7. Weltings S, Schout BMA, Roshani H, Kamphuis GM, Pelger RCM. Lessons from Literature: Nephrostomy Versus Double J Ureteral Catheterization in Patients with Obstructive Urolithiasis-Which Method Is Superior? J Endourol. 2019; 33(10): 777-786.
8. Xu ZH, Yang YH, Zhou S, Lv JL. Percutaneous nephrostomy versus retrograde ureteral stent for acute upper urinary tract obstruction with urosepsis. J Infect Chemother. 2021; 27(2): 323-328.
9. Sorlí L, Luque S, Li J, et al. Colistin for the treatment of urinary tract infections caused by extremely drug-resistant Pseudomonas aeruginosa: Dose is critical. J Infect. 2019; 79(3): 253-261.
10. Đạm LĐ, Hùng NK, Khánh LĐ. Treatment upper urinary tract infection in the patient with obstructive urolithiasis. Tạp chí Y Dược học. 2021; 6(6): 9.
11. Nguyễn Phúc Cẩm Hoàng, Huỳnh Thắng Trận, Trần Vĩnh Hưng. Đánh giá vai trò của soi niệu quản đặt thông jj trên bệnh nhân nhiễm khuẩn huyết từ đường niệu có sỏi niệu quản tắc nghẽn. Tạp chí Y học Thành phố Hồ Chí Minh Phụ bản tập 20, số 4. Published online 2016: 82-88.
12. Lim C, Hwang J, Kim D, et al. Risk Factors of Sepsis in Obstructive Acute Pyelonephritis Associated with Urinary Tract Calculi. Urogenital Tract Infection. 2015; 10:108.
13. Nguyễn Ngọc Châu, Nguyễn Phúc Cẩm Hoàng, Trần Vĩnh Hưng. Hiệu quả của phương pháp nội soi niệu quản đặt thông jj trong điều trị thận ứ nước nhiễm trùng – nhiễm khuẩn huyết từ đường niệu có tắc nghẽn. Tạp chí Y học Thành phố Hồ Chí Minh. Phụ bản tập 20, số 4. 2016: 42-47.
14. Blackwell RH, Barton GJ, Kothari AN, et al. Early Intervention during Acute Stone Admissions: Revealing “The Weekend Effect” in Urological Practice. Journal of Urology. 2016; 196(1): 124-130.
15. Chang UI, Kim HW, Noh Y sun, Wie SH. A comparison of the clinical characteristics of elderly and non-elderly women with community-onset, non-obstructive acute pyelonephritis. Korean J Intern Med. 2015; 30(3): 372-383.
16. Pertel PE, Haverstock D. Risk factors for a poor outcome after therapy for acute pyelonephritis. BJU Int. 2006; 98(1): 141-147.
17. Nguyễn Ngọc Châu, Nguyễn Phúc Cẩm Hoàng, Trần Vĩnh Hưng. Hiệu quả của phương pháp nội soi niệu quản đặt thông jj trong điều trịthận ứnước nhiễm trùng –nhiễm khuẩn huyết từ đường niệu có tắc nghẽn. Published online 2016: 77-82.
18. Yamamoto Y, Fujita K, Nakazawa S, et al. Clinical characteristics and risk factors for septic shock in patients receiving emergency drainage for acute pyelonephritis with upper urinary tract calculi. BMC Urol. 2012; 12:4.
19. Ngô Xuân Thái, Trần Hữu Toàn. Giá trị của điểm số qSOFA, SOFA trong chẩn đoán và kết quả điều trị nhiễm khuẩn huyết và choáng nhiễm khuẩn ở bệnh nhân bế tắc đường tiết niệu trên. Published online 2021: 199-204.
20. Perry WM. Identification Of Factors Associated With Acute Pyelonephritis Complicated By Ureteral Stones. In: ; 2013.
21. Stewart A, Joyce A. Modern management of renal colic. Trends in Urology, Gynaecology & Sexual Health. 2008; 13(3): 14-17.
22. Pham PC, Khaing K, Sievers TM, et al. 2017 update on pain management in patients with chronic kidney disease. Clin Kidney J. 2017; 10(5): 688-697.
23. Choong FX, Antypas H, Richter-Dahlfors A. Integrated Pathophysiology of Pyelonephritis. Microbiol Spectr. 2015; 3(5): 503-522.
24. Buonaiuto VA, Marquez I, De Toro I, et al. Clinical and epidemiological features and prognosis of complicated pyelonephritis: a prospective observational single hospital-based study. BMC Infect Dis. 2014; 14: 639.
25. Spoorenberg V, Prins JM, Opmeer BC, de Reijke TM, Hulscher MEJL, Geerlings SE. The additional value of blood cultures in patients with complicated urinary tract infections. Clin Microbiol Infect. 2014; 20(8): 476-479.
26. Tambo M, Okegawa T, Shishido T, Higashihara E, Nutahara K. Predictors of septic shock in obstructive acute pyelonephritis. World J Urol. 2014; 32(3): 803-811.
27. Tambo M, Taguchi S, Nakamura Y, Okegawa T, Fukuhara H. Presepsin and procalcitonin as predictors of sepsis based on the new Sepsis-3 definitions in obstructive acute pyelonephritis. BMC Urol. 2020; 20:23.
28. Xu RY, Liu HW, Liu JL, Dong JH. Procalcitonin and C-reactive protein in urinary tract infection diagnosis. BMC Urol. 2014; 14:45.
29. Nencka P, Zachoval R, Záleský M, et al. C15 Role of procalcitonine in diagnostics of acute pyelonephritis. European Urology Supplements. 2009; 8(8): 662.