Abstract
We report a case of pyonephrosis successfully treated by percutaneous nephrostomy and clean intermittent catheterization. A 66-year-old female, who had undergone radical hysterectomy and radiation therapy in 1967 and maintained on hemodialysis since 1987, was admitted to our hospital because of right flank pain and low grade fever in July 1996.
Abdominal CT revealed a solid mass in the right renal pelvis, bilateral hydronephrosis and extremely enlarged bladder. We diagnosed right renal bleeding and bilateral hydronephrosis due to neurogenic bladder caused by radical hysterectomy. Antibiotics were administered and clean intermittent catheterization and bladder washout were performed. Percutaneous nephrostomy was performed on August 8 because of high fever. After pyonephrosis was resolved, percutaneous biopsy of the right renal pelvis revealed grnulous tissues.
The nephrostomy tube was removed on November 9, 1996. We conclude that pyonephrosis could be resolved conservatively with percutaneous nephrostomy and intermittent catheterization in neurogenic bladder patient on long-term hemodialysis.
