In addition, severe pyelonephritis usually requires hospitalization for three to about five days to monitor the general condition and for antibiotic therapy via a vein. If the inflammation of the renal pelvis is caused by restricted urine flow from the kidney, we usually have to operate. Untreated pyelonephritis can lead to a loss of kidney function or blood poisoning. Blood poisoning can be life-threatening if it is not treated within a short time.
Procedure
The first step is a brief consultation to determine the possible causes of the pelvic inflammatory disease. We will take a urine sample to identify the underlying bacterium causing the inflammation. A blood test is also often carried out. This can be used to assess the severity of the inflammation and the kidney function. A physical and ultrasound examination of the kidneys and urinary bladder (possibly including computer tomography) of the abdomen round off the visit to the doctor. If there is also a bladder dysfunction, a catheter is temporarily inserted into the bladder to drain the contaminated urine.
Mild to moderate degrees of inflammation can be treated on an outpatient basis. Patients take an antibiotic in tablet form or come to us daily for intravenous antibiotic therapy. Regular medical check-ups are necessary to detect a worsening of the pyelonephritis at an early stage. In cases of moderate to severe severity and restricted urine flow from the kidney, inpatient treatment with close monitoring and possible surgery is essential. If the patient responds well to treatment, discharge home is usually possible after three to about five days of treatment, provided that the prescribed antibiotic treatment can be continued at home (often for up to two weeks).
If urinary retention is one of the causes of pyelonephritis, urine drainage must be restored. This is done in a short, emergency operation lasting approx. 15 – 30 minutes via the urethra without an external incision. This involves inserting a ureteral catheter (pigtail catheter) or, rarely, a drain directly via the renal pelvic system (nephrostomy). If stones restrict the ureteral outflow, they are surgically removed during a second hospital stay after the infection has been treated. Stone removal during the infection poses an increased health risk.
