INITIAL OUTCOMES OF EMERGENCY DECOMPRESSION IN PATIENTS WITH INFECTED UPPER URINARY TRACT OBSTRUCTION
Main Article Content
Abstract
Introduction: Infected upper urinary tract obstruction is a urological emergency associated with urosepsis and acute kidney injury. Urgent decompression is essential, yet the optimal approach remains debated.
Objectives: To describe clinical/paraclinical characteristics and etiologies, and to assess early outcomes of emergency decompression.
Methods: A prospective case series study with short-term follow-up was conducted on 44 patients with infected upper urinary tract obstruction who underwent temporary decompression at Can Tho Central General Hospital and Can Tho University of Medicine and Pharmacy Hospital from May 2024 to November 2025
Results: The mean age was 61,2±13,3 years; the male-to-female ratio was 1:1,59. Fever occurred in 47,7% and costovertebral angle tenderness was positive in 38,6% of cases. Laboratory findings showed mean WBC 13,1±5,2 (109/L), CRP 38,5±95,2 (mg/L), and PCT 10,2±17,9 (ng/mL). Hydronephrosis grades 1, 2, and 3 were recorded at 22,7%, 15,9%, and 61,4%, respectively. The most common etiology was ureteral stones (63.6%). Urine culture was positive in 18,2% of patients, with Escherichia coli accounting for 7/8 cases. Decompression was performed via retrograde ureteral stenting (28 cases) and percutaneous nephrostomy (16 cases); the technical success rate was 93,2% with no recorded mortality. Post-intervention, WBC, CRP, and PCT levels significantly decreased while eGFR significantly increased (Wilcoxon test: Z from −4,575 to −5,497; p < 0,001).
Conclusions: In patients with infected upper urinary tract obstruction, ureteral stones are the primary cause and E. coli is the most common pathogen in positive cultures. Temporary decompression is highly effective and leads to marked improvement in both inflammatory status and renal function.
Keywords
Upper urinary tract obstruction, temporary decompression, Percutaneous nephrostomy / Ureteral stenting
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References
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