From the Guidelines
Pyelocystitis of the kidneys is not a recognized medical term, however, based on the provided evidence, it can be inferred that the question is referring to pyelonephritis, which is a severe urinary tract infection that affects the renal pelvis and kidney. The term "pyelonephritis" implies that there is inflammation of the renal pelvis and kidney, and it often presents with signs and symptoms of both systemic inflammation and bladder inflammation 1.
Key Points
- Acute pyelonephritis (APN) is a severe urinary tract infection that has the potential to cause sepsis, shock, and death 1.
- The annual incidence of APN is 459,000 to 1,128,000 cases in the United States and 10.5 to 25.9 million cases globally 1.
- APN often presents with signs and symptoms of both systemic inflammation (eg, fever, chills, and fatigue) and bladder inflammation (eg, urgency, dysuria, and urinary frequency) 1.
- Clinical presentation of APN can range from mild flank pain with low-grade or no fever to septic shock, and up to 20% of patients lack bladder symptoms 1.
Diagnosis and Treatment
- In patients with flank pain or tenderness, without or with voiding symptoms, without or with fever, and with a urinalysis showing pyuria and/or bacteriuria, APN is an appropriate presumptive diagnosis 1.
- Urine cultures yielding >10,000 colony-forming units of a uropathogen per milliliter of urine is the fundamental confirmatory diagnostic test 1.
- Positive blood cultures may assist with the diagnosis 1.
- In the majority of patients, uncomplicated APN is diagnosed clinically and is responsive to treatment with appropriate antibiotics 1.
Risk Factors
- Risk factors for cystitis predispose to APN and include sexual activity, new sexual partner, spermicide exposure, personal or maternal history of UTIs, genetic predisposition, and diabetes mellitus 1.
- Factors that disrupt urinary flow such as vesicoureteral reflux, congenital urinary tract anomalies, altered bladder function, pregnancy, renal calculi, or mechanical obstruction increase the risk of developing APN 1.
From the Research
Definition and Overview of Pyelocystitis
- Pyelocystitis is not directly defined in the provided studies, but it can be inferred to be related to infections or inflammation of the kidney and renal pelvis.
- The studies focus on the treatment of upper urinary tract stones, which can be a cause of pyelocystitis 2, 3, 4, 5, 6.
Relationship with Upper Urinary Tract Stones
- Upper urinary tract stones can cause obstructive pyelonephritis, which is an infection of the kidney and renal pelvis 3.
- The treatment of upper urinary tract stones, such as extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy, can help prevent or resolve pyelocystitis 2, 3, 4, 5, 6.
Treatment Options
- ESWL is a common treatment option for upper urinary tract stones, but it may cause complications such as renal obstruction and pyelonephritis 2, 4, 6.
- Ureteroscopy is another treatment option, which can be used after drainage of an obstructed infected kidney, and has been shown to be safe and effective 3.
- Percutaneous nephrolithotomy (PCNL) is also a treatment option, especially for larger stones or stones in patients with chronic kidney disease 5.