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Seminars in Interventional Radiology Mar 2021Traumatic injuries to the kidney and collecting system can range widely from small lacerations to significant bleeding and its sequelae. Urinary obstruction can occur in... (Review)
Review
Traumatic injuries to the kidney and collecting system can range widely from small lacerations to significant bleeding and its sequelae. Urinary obstruction can occur in the renal pelvis, ureters, or urethra. Interventional radiology plays a significant role in treatment and management, in many cases requiring emergent action. Endovascular embolization is frequently the first-line approach to treating hemorrhage. Percutaneous interventions for urinary obstruction include nephrostomy and suprapubic catheter placement. In this article, we outline the clinical approach and interventional methods used in the evaluation and treatment of renal trauma. Several case presentations demonstrate the role of interventional radiology in renal trauma.
PubMed: 33883808
DOI: 10.1055/s-0041-1726006 -
Archivos Espanoles de Urologia Jul 2021Encrusted pyelitis in an infection caused by Corynebacterium Urealyticum. The incidence has increased, specially in immunosuppressed patients and patients with...
OBJECTIVE
Encrusted pyelitis in an infection caused by Corynebacterium Urealyticum. The incidence has increased, specially in immunosuppressed patients and patients with indwelling urinary catheters.
METHODS
We are presenting a case of a 72 years old male with Bricker urinary derivation with an ureteral catheter. During the follow up, catheteral calcification and encrusted pyelitis were found in TC images and cultures were positive for Corynebacteirum Urealitycum. This condition was managed with endoscopic and medical treatment; that consisted in antibiotics and acidification of urine through nephrostomy tube using an acidifying irrigation solution and Lit-Control pH Down orally, in order to avoid new infections.
RESULTS
Treatment was effective, no new reinfections were shown with the use of Lit-Control pH Down for the maintenance.
CONCLUSIONS
The suspected diagnosis and the early treatment of encrusted pyelitis avoid complications. Antibiotics and urine acidification are key in the treatment of this disease.
Topics: Aged; Corynebacterium; Corynebacterium Infections; Humans; Male; Pyelitis; Urinary Catheters
PubMed: 34219065
DOI: No ID Found -
IDCases 2021A 57-year-old man presenting with bilateral flank pain and hematuria was found to have severe bilateral emphysematous pyelonephritis. The patient was managed with a...
A 57-year-old man presenting with bilateral flank pain and hematuria was found to have severe bilateral emphysematous pyelonephritis. The patient was managed with a conservative approach consisting of systemic antimicrobials and decompression via percutaneous nephrostomy tubes with piperacillin-tazobactam instillations via nephrostomy and made a full recovery.
PubMed: 33532239
DOI: 10.1016/j.idcr.2020.e01042 -
Cureus Jan 2024The aim of this article is to provide a literature review on the management of symptomatic physiological hydronephrosis in pregnancy and compare different modalities of... (Review)
Review
The aim of this article is to provide a literature review on the management of symptomatic physiological hydronephrosis in pregnancy and compare different modalities of intervention when needed. In this review, we conducted an electronic literature search of peer-reviewed journal articles. The PubMed, Research Gate, and Google Scholar databases were queried with the following search terms: "pregnancy", "obstruction," and "hydronephrosis"; the terms "urolithiasis" and "kidney stone" were excluded. As a result, conservative treatment was successful and more favored for most of the patients and the clinicians in the different studies we found. Conservative management will usually include regular analgesia, positioning, and antibiotics. Close follow-up with ultrasound is always recommended. Intervention with ureteric stent insertion or nephrostomy tube insertion was less favored and only triggered by certain clinical criteria. In conclusion, symptomatic hydronephrosis in pregnancy can be safely treated conservatively. However, ureteral double-J stenting or percutaneous nephrostomy are effective and safe treatment methods in the minority of patients with persistent symptoms not responding to conservative management.
PubMed: 38222991
DOI: 10.7759/cureus.52146 -
Ultrasound (Leeds, England) Nov 2022Urinary tract obstruction (UTO) is a common clinical problem of which there are many potential causes. The aim of this feature article is to explore the role of...
INTRODUCTION
Urinary tract obstruction (UTO) is a common clinical problem of which there are many potential causes. The aim of this feature article is to explore the role of ultrasound in diagnosing UTO, during guided interventional procedures and the potential procedural complications. Ultrasound is an integral imaging modality throughout the management pathway of a patient with UTO and is often utilised as a first-line test in diagnosis and treatment. Percutaneous nephrostomy is an interventional technique, usually performed by radiologists or interventional sonographers, as either a short- or long-term management strategy. It can either be used in isolation or to gain access to the renal collecting system prior to more complex interventional or surgical techniques. Ultrasound-guided interventional techniques to relieve UTO can be employed in a number of clinical scenarios each with their own indications, contraindications and complications.
CONCLUSION
Ultrasound plays a unique role in the planning and active stages of intervention with the provision of dynamic imaging which is crucial for providing safe and effective patient management.
PubMed: 36969536
DOI: 10.1177/1742271X211049495 -
Clinical Case Reports Dec 2020An infectious disease with obstructive hydronephrosis, pyonephrosis causes suppurative destruction of the renal parenchyma. In such cases, retrograde ureteric stenting...
An infectious disease with obstructive hydronephrosis, pyonephrosis causes suppurative destruction of the renal parenchyma. In such cases, retrograde ureteric stenting is considered a good choice for the drainage of pyonephrosis, as an alternative to percutaneous nephrostomy and nephrectomy. The complication rate is minimal in retrograde ureteric stenting compared with about 4% in percutaneous nephrostomy.
PubMed: 33363990
DOI: 10.1002/ccr3.3204 -
Current Urology Mar 2023Urolithiasis is the most common cause of nonobstetric abdominal pain, resulting in 1.7 admissions per 1000 deliveries. Urolithiasis most commonly occurs in the second...
Urolithiasis is the most common cause of nonobstetric abdominal pain, resulting in 1.7 admissions per 1000 deliveries. Urolithiasis most commonly occurs in the second and third trimesters, with an incidence between 1:125 and 1:2000. Acute urinary system obstructions are challenging to manage in obstetric patients because they contribute to physiological and anatomical changes that result in pathological outcomes. The restricted use of computed tomography in diagnosing and managing urolithiasis is particularly challenging. In addition, a prompt diagnosis is required because the presence of renal calculi during pregnancy increases the risk of fulminating sepsis and preterm delivery. Affected pregnancies are conservatively managed; however, 1 in 4 requires surgical intervention. Indications for surgical interventions are complex and range from nephrostomy insertion to empirical stent placement or ureteroscopy. Therefore, a multidisciplinary approach is required to optimize patient care. The diagnosis and management of urolithiasis in pregnancy are complex. We reviewed the role, safety, advantages and disadvantages of diagnostic tests and treatment used to manage acute urinary obstructions in pregnancy.
PubMed: 37692143
DOI: 10.1097/CU9.0000000000000181 -
Urology Annals 2021Myiasis is caused by the presence of dipterous larvae in humans and animals. It is usually associated with poor hygienic conditions. A urologist rarely comes across...
Myiasis is caused by the presence of dipterous larvae in humans and animals. It is usually associated with poor hygienic conditions. A urologist rarely comes across myiasis. We report a case of myiasis around a recently placed nephrostomy tube. A 55-year-old male farmer from a rural area underwent right percutaneous nephrolithotomy. The procedure was terminated because of bradycardia and arrhythmia. There were residual calculi. A nephrostomy was kept. His relook nephroscopy was planned, but he was not willing. Hence, he was discharged with an indwelling nephrostomy tube. Two weeks later, he presented with severe pain around the right nephrostomy tube with surrounding pruritus. The wound hygiene was poor. He was found to have maggots around the nephrostomy tube. These were treated by local instillation of turpentine oil and oral and topical ivermectin, followed by manual removal of the maggots.
PubMed: 34759660
DOI: 10.4103/UA.UA_185_20