ASPECTS OF THE UPPER URINARY TRACT DRAINAGE IN PATIENTS WITH ACUTE OBSTRUCTIVE PYELONEPHRITIS

In Ukraine, acute pyelonephritis is considered to be a widespread urologic inflammatory pathology with a tendency to increase in morbidity rate requiring active treatment policy. Acute obstructive pyelonephritis arises if there is any existing obstruction of the upper urinary tract. Minimally invasive technique directed at eliminating obstruction has to be included to treatment measures. Currently, there are two methods of urgent restoration of normal urinary flow: percutaneous nephrostomy (PNS) and ureteral stenting. The objective of this research was to compare the efficacy and safety of both techniques in the treatment of patients with acute obstructive pyelonephritis. Having analyzed 373 patients’ case histories, it has been established that technical success of PNS and stenting constituted 98.9% and 92.6%, respectively (p < 0.05). The duration of drainage of the urinary tract was 7 ± 1 days in PNS group and 14 ± 1 days in stenting group. General incidence of complications associated with PNS was 15.5%, while incidence of complications associated with ureteral stenting was 28.6% (p < 0.05). It has been concluded that percutaneous nephrostomy can be considered as an effective method of drainage of the upper urinary tract in patients with acute obstructive pyelonephritis providing higher technical success (98.9% vs. 92.6%, p < 0.05), lower incidence of complications (15.5 % vs. 28.6%, p < 0.05) and better quality of life compared to ureteral stenting.