Pyelonephritis is a purulent inflammation of the pyelocaliceal system of the kidney and its parenchyma. The cause is a bacterial infection that usually extends upward from the bladder. Uncomplicated pyelonephritis is successfully treated with antibiotics. In case of complicated pyelonephritis, the help of surgeons is often required. Even in a complicated form of the disease, the treatment of pyelonephritis in Germany is minimally traumatic, safe, and allows the patient to save the kidney and avoid urosepsis.
Content
- Conservative treatment
- Surgery
Pyelonephritis is usually cured with antibiotics. Operations are performed only in case of complications. Sometimes a minimally invasive percutaneous procedure using a needle can be done instead of surgery. If surgical treatment is required, German doctors perform a retroperitoneoscopic operation to open purulent foci, remove dead tissues and place drains.
You can contact the following clinics: University Hospital of Ludwig Maximilian University of Munich, Charite University Hospital Berlin, University Hospital Rechts der Isar Munich.
Booking Health will arrange your trip to Germany. We will help you select a clinic and a doctor, make an appointment as early as possible (without being on a long waiting list), apply for a visa, and get to the clinic. The company's managers will take care of the airline tickets, accommodation and transfer; we will translate your medical reports into German so that you do not have to undergo previously performed examinations. During treatment, you can contact your personal medical coordinator for any question.
Conservative treatment
Young patients with uncomplicated pyelonephritis can be treated as outpatients. Hospital admission is indicated to:
- elderly people;
- children;
- pregnant women;
- patients with severe pyelonephritis;
- patients with weak immunity;
- patients with concomitant diseases, for example, diabetes mellitus;
- patients with structural anomalies of the kidneys.
As the first-line option, patients receive drug therapy. Non-steroidal anti-inflammatory drugs are used to reduce pain and inflammation. They lower body temperature.
Antibiotics are used to suppress infection in the kidneys. Initially, they are prescribed empirically: namely, according to the standard regimen, to destroy the most common bacteria that cause pyelonephritis.
Even before the beginning of antibiotic therapy, urine samples are taken for bacteriological culture. In a few days, bacterial culture grows on the nutrient medium. As a result, it is possible to establish not only the type of pathogen, but also its sensitivity to various antibiotics. According to the antibiogram, treatment can be adjusted, if it is not effective enough.
Most cases of pyelonephritis are caused by E.coli (Escherichia coli). It is destroyed by cephalosporins or fluoroquinolones. The course of therapy is 14 days. Antibiotics are taken orally – in pills or capsules.
In complicated cases of pyelonephritis, therapy begins with intravenous administration of antibacterial agents. This method of drug administration ensures more predictable pharmacodynamics: the absorption of drugs does not depend on the state of the digestive tract. After the condition improves, the patient is treated with oral antibiotics.
Surgery
Operations for pyelonephritis are carried out in case of destructive forms. They are characterized by severe purulent inflammation with destruction of kidney tissue. Without treatment, the infection can extend to other organs and cause urosepsis.
The essence of the treatment is to remove the purulent focus and to ensure the outflow of the inflammatory fluid. Sometimes physicians have to remove the entire kidney, but German doctors avoid such operations. They are performed only in the most severe cases, when it is impossible to save the patient's life in another way.
German surgeons usually perform organ-preserving interventions. During the operation, a revision of the retroperitoneal space and a kidney, its release from the capsule, dissection of purulent foci, opening of abscesses, removal of non-viable tissues and the nephrostomy are performed.
Instead of operations, minimally invasive procedures are increasingly being used in German clinics, as they are safer. Minimally traumatic percutaneous treatment is better tolerated and reduces rehabilitation. The purulent focus is removed with a needle. To drain urine, percutaneous puncture nephrostomy is performed. Such procedures are possible in purulent foci inflammation with the size of up to 3 cm.
If an operation is required, then in Germany it is performed with the help of retroperitoneoscopic technique. Doctors insert thin long instruments into the retroperitoneal space through short incisions. In this case, the surgeon's hands are out of the wound. All manipulations are performed under the guidance of a tiny video camera. Retroperitoneoscopic surgery allows revising the retroperitoneal space and perinephric tissues (tissues surrounding the kidney), opening of abscesses and removing dead tissues. At the final stage of the operation, doctors place optimally sized drainage tubes to drain pus and wash the wound with antiseptics.
You can go to Germany to undergo diagnostics and treatment of pyelonephritis. In most cases, doctors manage to cope with this disease with conservative methods. In destructive forms, minimally invasive procedures are used. If an operation is required, then it is usually organ-preserving. Specialized centers perform minimally invasive retroperitoneoscopic interventions instead of open ones.
You are welcome to use the Booking Health service to check prices and book a treatment at a favorable cost. The specialists of our company will help you select clinics in Germany and arrange your trip.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Farrukh Ahmed. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
Centers for Disease Control and Prevention
The Lancet
Google Scholar
