Strategy for the Renal
Abscesses Treatment
Pešl M., Zámečník L., Pokuta P., Soukup V., Dvořáček J.
Urologická klinika VFN a 1. LF UK, Praha, přednosta prof. MUDr. J. Dvořáček, DrSc. |
|
Summary:
Aim: A retrospective assessment of treatment results in a group of patients treated for renal abscesses by our
work team during the last five years. The aim is to determine the most suitable therapeutical approach for each
abscess group, depending on their size.
Patients and Methodology: There were 13 patients in the group (10 of them were women and 3 of them were
men, aged 36, on average). The ultrasound examination of the kidneys was conducted using the 5MHz appliance.
In cases when antibiotics were prescribed, they were prescribed in combination, most often ampicillin and
gentamycine. The evacuation percutaneous punction of the absces cavity was carried out using a standard
technique under the sonographic control. The kidney was approached via lumbotomy during the nefrectomy
procedure.
Results: The hospitalization lasted for 19 days on average (5–72 days). The right and left kidney involvement
ratio was 5:8. In four cases we chose a conservative approach, in all cases, the patients concerned were treated
during the previous three years. The abscess cavity measured 2,75 cm on average, in the above patients cases.
Eight patients underwent a percutaneous punction of the abscess cavity. The average size of the renal abscess
was 5.5 cm in this patient group. One patient underwent nephrectomy. The patient concerned was immunosupressed.
Three- to four months after the treatment commenced, the control CT scan revealed no residual abscess
foci.
Conclusion: The medium-sized renal abscesses may be solved using a percutaneous abscess punction. The
small-sized abscesses may be successfully solved using antibiotics, introduced parenteraly. The conservative
treatment is considered inappropriate in cases of immunocompromized patients and for abscesses larger than 5
cm.
Key words:
renal abscess – ultrasound – conservative approach – punction
|