FREQUENCY, SEVERITY, CAUSES OF DEVELOPMENT OF COMPLICATED PYELONEPHRITIS AFTER EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY AND PREVENTION METHODS

Аннотация

Purpose of the study. Improving the results of extracorporeal shock wave lithotripsy by reducing the frequency and severity of postoperative infectious and inflammatory complications. Material and methods. We have analyzed the results of treatment of 330 patients with urolithiasis who applied to the RSSPM Center of Urology in the period from January 2019 to July 2022 with the stone/s of the upper urinary tract (URT). The first control group consisted of 200 patients subjected to ESWL with the study of the frequency, severity and causes of acute complicated pyelonephritis. The size of the stones was 9.0 ± 0.2 (4-16 mm), in 71 (35.5%) stones were located in the pelvicalyceal system (PCS), in 129 (64.5%) in the ureter. 146 (73%) had urinary tract infection. Results. Among the 1st group of patients, the "stone free rate" was 186 (93.0%), in the post-procedural period, acute complicated pyelonephritis was observed in 2 (1.0%), urosepsis in 1 (0.5%). Among the patients of group II, the «stone free rate» was 115 (88.5%) after the first ESWL session; no infectious and inflammatory complications were observed in the post-procedure period. Conclusions. The basis for the prevention of infectious and inflammatory complications of extracorporeal shock wave lithotripsy is the constant monitoring of complications and the study of risk factors for their occurrence. Cancellation of prophylactic antibiotic administration 1 hour before ESWL in patients without urinary tract infection and by exclusion of other risk factors for infectious complications does not lead to the development of post-procedure pyelonephritis and thereby reduces the overall costs associated with the treatment of the patient.