Objectives: To systematically review the current demographics, treatment and mortality rate associated with xanthogranulomatous pyelonephritis (XGP) and to test the hypothesis that the weighted pooled peri-operative mortality rate will be <10%.
Methods: Searches were performed of the Cochrane, Embase and Medline databases and the grey literature for studies published during the period 1 January 2000 to 30 August 2021. Eligible studies reported cohorts of ≥10 predominantly adult patients with XGP and described either average patient age or mortality rate.
Results: In total, 40 eligible studies were identified, representing 1139 patients with XGP. There were 18 deaths, with a weighted pooled peri-operative mortality rate of 1436 per 100 000 patients. The mean age was 49 years, 70% of patients were female and 28% had diabetes mellitus. The left kidney was more commonly affected (60%). Four patients had bilateral XGP, and all of whom survived. Renal or ureteric stones were present in 69% of patients, including 48% with staghorn calculi. Urine culture was positive in 59% of cases. Fistulae were present in 8%. Correct preoperative diagnosis occurred in only 45% of patients. Standard treatment continues to comprise a short cause of antibiotics and open radical (total) nephrectomy. Preoperative decompression occurred in 56% of patients. When considered at all, laparoscopic nephrectomy was performed in 34% of patients. Partial nephrectomy was conducted in 2% of patients.
Conclusions: Xanthogranulomatous pyelonephritis has a lower mortality rate than historically reported. A typical patient is a woman in her fifth or sixth decade of life with urolithiasis. While open radical nephrectomy remains the most common treatment method, laparoscopic, and to a lesser degree partial nephrectomy, are feasible in well selected patients.
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http://dx.doi.org/10.1111/bju.15878 | DOI Listing |
Septic cardiomyopathy (SCM) is a reversible cardiac dysfunction occurring in patients with sepsis or septic shock, characterized by transient impaired myocardial contractility. Despite its prevalence in severe sepsis and significant impact on patient outcomes, SCM remains underdiagnosed and is one of the least studied forms of cardiomyopathy. Its recognition and management are further complicated by the absence of a universally accepted consensus on its diagnostic criteria and definition.
View Article and Find Full Text PDFUrologia
November 2024
Department of Urology, All India Institute of Medical Sciences, Jodhpur, India.
Introduction: Laparoscopic simple nephrectomy (LSNx) is among the gold standard options for management of selected poorly functioning and most non-functioning kidneys (PFK/NFKs). Our objective was to audit our patients who had undergone LSNx for benign causes and assess their perioperative outcomes and analyse the factors correlating with these outcomes.
Materials And Methods: We reviewed our prospectively collected data of patients with PFK/NFKs due to benign causes who underwent a LSNx on a three-dimensional (3D) system via a transperitoneal approach between January 2017 and June 2023.
Urol Clin North Am
February 2025
Department of Radiology, Beaumont Hospital, 27 Bishopsmede, Clanbrassil Street Upper, Dublin D08 kV62, Ireland. Electronic address:
Urinary infections are common. Typically, infections of the upper and lower urinary tract do not require imaging. However, in the presence of confirmed or suspected complicated urinary tract infections, imaging to assess for underlying causes and complications is required.
View Article and Find Full Text PDFPediatr Nephrol
November 2024
Steve Biko Academic Hospital, Department of Paediatrics, School of Medicine, University of Pretoria, Pretoria, South Africa.
Xanthogranulomatous pyelonephritis is a rare condition in paediatric patients, mostly described in middle-aged female patients. We present a 7-year-old female with juvenile idiopathic arthritis, who was found to have a kidney mass with a concurrent Escherichia coli urinary tract infection. Surgical excision was done out of concern for possible malignancy.
View Article and Find Full Text PDFJ Nephrol
October 2024
Division of Nephrology, Department of Internal Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.
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