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Risk Factors of Sepsis and Factors Influencing the Decision to Perform Emergency Drainage in Obstructive Acute Pyelonephritis Secondary to Urinary Calculi
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Young Hwan Jung, Seung Chan Jeong, Minki Baek, Dong Soo Ryu
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Urogenit Tract Infect 2017;12(3):110-116. Published online December 31, 2017
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 Abstract
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- Purpose: To investigate the risk factors for sepsis and analyze the criteria for emergency drainage in patients with obstructive acute pyelonephritis (APN) secondary to urinary calculi.
Materials and Methods: We included 64 patients with obstructive APN secondary to urinary calculi. Patients were divided into two groups: the sepsis and non-sepsis groups. Independent risk factors for sepsis were also identified. Forty-three patients in the sepsis group were further divided into two subgroups: those who underwent emergency drainage and those who did not. A retrospective analysis was performed.
Results: Of the 64 patients, 43 showed signs of sepsis. There was a lower lymphocyte count and lymphocyte percentage, as well as a higher C-reactive protein level and neutrophil-to-lymphocyte ratio (NLR) in the sepsis group compared with the non-sepsis group. Increased sepsis showed a statistically significant association with increased Charlson comorbidity index (CCI). Four out of 21 patients in the non-sepsis group underwent emergency drainage compared with 26 out of 43 patients in the sepsis group. Independent variables for sepsis in a multivariate logistic regression analysis showed positive blood culture, high NLR, and increased CCI score. Among sepsis patients, the likelihood of performing emergency drainage increased with higher creatinine, positive urine culture, and higher CCI score.
Conclusions: In patients with obstructive APN secondary to urinary calculi, a high CCI score were associated with a higher probability of progression to sepsis. In patients with higher creatinine and higher CCI scores, proactive treatment is usually necessary.
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Mondor’s Disease of the Penis Mistaken for Penile Fracture
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Young Hwan Jung, Dong Soo Ryu
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Urogenit Tract Infect 2016;11(1):39-41. Published online April 30, 2016
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Abstract
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- Superficial thrombophlebitis of the dorsal vein of the penis, known as penile Mondor’s disease, is an uncommon genital disease. We report on a healthy 44-year-old man who presented with painful penile swelling, ecchymosis, and penile deviation after masturbation, which initially imitated a penile fracture. Thrombosis of the superficial dorsal vein of the penis without rupture of corpus cavernosum was found during surgical exploration. The patient recovered without erectile dysfunction.
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