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Characteristics and Treatment Trends for Emphysematous Pyelonephritis in Korea: A 10-Year Multicenter Retrospective Study
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Seung-Kwon Choi, Koo Han Yoo, Jeong Woo Lee, Seung Il Jung, Eu Chang Hwang, Joongwon Choi, Woong Bin Kim, Jung Sik Huh, Jin Bong Choi, Yeonjoo Kim, Jae Min Chung, Ju-Hyun Shin, Jae Hung Jung, Hong Chung, Sangrak Bae, Tae-Hyoung Kim
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Urogenit Tract Infect 2021;16(2):49-54. Published online August 31, 2021
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DOI: https://doi.org/10.14777/uti.2021.16.2.49
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 Abstract
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- Purpose: This study examined the characteristics, current treatment trends, and outcomes of patients with emphysematous pyelonephritis (EPN) in Korea.
Materials andMethods: Two hundred and seventeen patients diagnosed with EPN were evaluated using abdominal computed tomography in 2011-2021 at 15 institutes in Korea. The patients’ demographic and clinical characteristics, treatment modalities, and treatment outcomes were analyzed. The total study period was divided arbitrarily into groups A (2011-2014), B (2015-2017), and C (2018-2021) to analyze the trends in the EPN treatment.
Results: The mean age of the patients was 65.1 years; there were more female patients (74.2%) than male patients. The overall mortality rate was 10.6%. Ninety-five (43.8%), 98 (45.2%), and 24 (11.0%) patients were treated with medical, minimally invasive, and surgical management, respectively; the corresponding mortality rates were 13.7%, 6.1%, and 16.7%. There was no significant change in the proportion of patients treated with medical management over time (group A=46.5%, group B=47.0%, and group C=38.8%). The proportion of patients treated with minimally invasive management gradually increased over time (group A=35.2%; group B=43.9%; group C=55.0%), while those who underwent surgical management decreased gradually over time (group A=18.3%, group B=9.1%, and group C=6.3%). No differences in mortality rates were observed between the groups.
Conclusions: EPN with medical and minimally invasive management had a relatively high treatment success rate, which increased gradually, while surgical management decreased gradually over time in Korea. The mortality rate was relatively lower than that reported in studies published before the 2010s.
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Bladder Stone causing Acute Renal Failure and Urinary Tract Infection
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Sung Dae Kim, Young Joo Kim, Jung Sik Huh
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Korean J Urogenit Tract Infect Inflamm 2012;7(2):178-181. Published online October 31, 2012
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Abstract
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- Bladder stones are not a rare disease, but it is rare for such a calculus to be so large as to cause bilateral hydronephrosis. In a previous report, we described an unusual case of spontaneous bladder rupture due to a giant bladder stone. The patient was a 68-year-old man, who had undergone primary repair of bladder rupture and cystolithotripsy of a giant bladder stone with lithoclast at the age of 63 years old. Then he did loss follow-up to the hospital for 5 years. After 5 years, he came back to the hospital with the same symptoms such as decreased urine volume, suprapubic discomfort. Fortunately, the previous treatment which consisted of litholopaxy and antibiotics was effective again. Worldwide, it is the first reported case of recurrent acute renal failure and urinary tract infection after bladder spontaneous rupture due to a giant bladder stone. (Korean J UTII 2012;7:178-181)
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