Pyonéphrose : Aspects cliniques et thérapeutiques à propos de 19 cas

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Introduction. Pyonephrosis is a serious and rare affection. Our goal was to describe the clinical and therapeutic features of pyonephrosis in our context. Patients and methods. This is retrospective study over a period of 10 years between January 2004 and December 2014 that allowed to collect 19 cases at 3 urological services. Results. The average mean age of our patients was 49 year old (extremes of 26 and 72 years). The sex ratio was 1.37. The majority of our patients consulted late with an average of 24 months. The infectious and painful syndromes were found in all patients. There was a deteriora- tion of general condition in 13 of our patients (68.42%). The Urine cultures was identified microorganisms in all patients. Renal function was impaired in 21.05% of patients. The diagnosis was demonstrated on a CT scan for all patients. All patients underwent pre and post operative intensive care. In 11 patients (57.89%) nephrostomy was first act before total nephrectomy. The post operative course period was simple with 57.89% (n=11). We recorded 5 death or 26.3% of cases. Patients were followed for a period of 1 to 5 years. The main causes of death were operations for neurosurgical (cerebral) disorders (29.4%), obstetrical pathologies (25.9%) and surgical and urological pathologies visceral (23.5%). They were represented by burnings (33.3%, 2 deaths of 6 cases), neurocranial trauma (21.4%, 25 deaths out of 92 cases) and polytrauma (12.2%, 6 deaths 49 cases). Conclusion. Pyonephrosis is a severe infection. Treatment of causal pathology is important to in preventing the affection.

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