Conservative Renal Surgery in Pyelonephritis: A Follow-up Study

Abstract

Thirteen patients with localized pyelonephritis in an otherwise apparently normal kidney and 22 patients with atrophic pyelonephritis, and sometimes also dysplasia, in one segment of a duplex kidney underwent partial nephrectomy. The indication for operation in both groups was recurrent urinary infection with or without refractory hypertension.

Twenty-nine of the patients were followed up 5 to 21 years after the operation. Recurrent urinary infection was present postoperatively in 10 of the 12 re-examined patients who had had focal inflammation in an otherwise normal kidney and in 8 of the 17 with duplex kidney. No favourable effect of surgery on hypertension was demonstrated.

In recurrent urinary infection and localized pyelonephritis, partial nephrectomy is indicated if the operation can also eradicate a cause of the infection. Renal hypertension per se does not constitute an indication for partial nephrectomy in adult patients.