Xanthogranulomatous pyelonephritis is an atypical severe renal parenchymal infection, characterized macroscopically by a yellow lobulated mass, and microscopically by massive inflammatory cells and foamyhystiocytes. Preoperatively it can be confused with hypernephroma, pyonephrosis with stone or other renal inflammatory diseases, We present a case of xanthogranulomatous pyelonephritis associated with xanthogranulomatous epididymoorchitis. To our knowledge this is the first report of xanthogranulomatous pyelonephritis associated with xanthogranulomatous epididymo-orchitis.
Carcinoma, Renal Cell ; Pyelonephritis, Xanthogranulomatous* ; Pyonephrosis

Xanthogranulomatous pyelonephritis is an atypical form of severe renal parenchymal infection, characterized by yellow lobulated masses macroscopically and massive inflammatory cell, foamy histiocyte microscopically. Preoperative diagnosis confused with hypernephroma, pyonephrosis with stone, other renal inflammatory disease. We report two cases of xanthogranulomatous pyelonephritis, diagnosed by microscopical finding and literature has been reviewed briefly.
Carcinoma, Renal Cell ; Diagnosis ; Histiocytes ; Pyelonephritis, Xanthogranulomatous* ; Pyonephrosis

Ultrasonography of rabbit kidney was erformed after induction of simple and infected hydronephrosis toevaluate the sequential sonographic changes in 27 rabbits. Simple hydronephrosis was induced by ligation of thedistal ureter and infected hydronephrosis by ligation of the distal ureter and ureteral inoculation of Escherichiacoli. Ultrasonography was performed daily during the first week and weekly during the following 5 weeks afterinductin of simple and infected hydronephrosis. The results are as follows; 1. In simple hydronephrosis, theearliest abnormal ultrasonographic finding was splitting of central renal echo complex, which appeared within 1day after ureteral ligation in all cases. 2. In simple hydronephrosis, complete loss of central renal echo complexand cystic dilatation of pelvis were seen with in 5 days after ureteral ligation in all cases. 3. In infectedhydronephrosis, the earliest abnormal ultrasonographic finding was appearance of internal lapse of time and theentire pelvis was filled with internal echoes within 2 weeks after inoculation in all cases. 5. In infectedhydronephrosis, echogenecity of internal echoes within the pelvis was similar to that of renal parenchma in thefirst week after inoculation, however was weaker than that of renal parenchyma 2 weeks after inoculation in all cases.
Dilatation ; Hydronephrosis ; Kidney ; Ligation ; Pelvis ; Pyonephrosis ; Rabbits ; Ultrasonography ; Ureter

We reviewed 27 infants and children with ureteroceles. There were four single system ureteroceles and 23 duplex system ureteroceles. Their various presentations, radiologic findings, operative managements and postoperative results were discussed. Diagnosis was readily made by excretory urography and voiding cystourethrography except two cases. In three cases of four single system ureteroceles, excision of ureteroceles and ureteral reimplantation were performed. Upper pole heminephrectomy was performed in 12 patients and total nephrectomy in two patients and half of these 14 patients required secondary operation on the bladder level. Upper pole heminephrectomy and ureteroneocystostomy of lower ploe ureter were performed in two cases. Transurethral incision of the ureterocele was the inital procedure in two cases to relieve the pyonephrosis and severe abdominal distention in infants and they all required the removal of the involved renal segment. Upper pole saving procedures were done in five patients. On long-term follow-up of 27 patients, 25 patients have been doing well. We think the management options of the ureterocele are to be decided individually based on the pathologic conditions and the renal function of the involved part.
Child* ; Diagnosis ; Follow-Up Studies ; Humans ; Infant* ; Nephrectomy ; Pyonephrosis ; Replantation ; Ureter ; Ureterocele* ; Urinary Bladder ; Urography

A retrospective analysis of 132 patients who underwent nephrectomy in the Department of Urology, Kyung Hee University Hospital, during the period from January 1972 to December 1980 was presented. The results were as follows: 1. The total number of in-patients during the above period was 2,301 and nephrectomies were performed in 132 of 1,427 total urologic operations (9.3%). 2. Age distribution showed the highest in 4th decade with 22.7%, the youngest was 11 months and the oldest 78 years, and male to female ratio was 68 to 64. 3. The causative diseases of the nephrectomy were renal tuberculosis 48 cases (36.4%), tumor 15 cases 11.4%. hydronephrosis 11 cases (8.3%), pyonephrosis 10 cases (7.6%), anomaly 8 cases (6.1%) and hypertension 6 cases (4.5%) in order. 4. Anterior abdominal extraperitoneal transverse approach was the most frequently used method in 103 cases (78.0%) 5. Post-operative complications were seen in 29 cases (22.0%), of which wound infection was common in anterior abdominal extraperitoneal transverse approach.
Age Distribution ; Female ; Humans ; Hydronephrosis ; Hypertension ; Male ; Nephrectomy ; Pyonephrosis ; Retrospective Studies ; Tuberculosis, Renal ; Urology ; Wound Infection

Sarcomatoid renal cell carcinoma is uncommon and constitutes approximately 1.0% to 1.5% of all renal parenchymal tumors. Renal tumors that consist of epithelial and sarcomatoid components were called Sarcomatoid renal cell carcinomas. Its distinction from other morphological variants of renal cell carcinoma is significant, because it has been shown to have a much poorer prognosis than the purely epithelial tumors. The diagnosis of sarcomatoid renal cell carcinoma is usually made when epithelial and sarcomatoid components are mixed in nephrectomy specimen. A case of sarcomatoid renal cell carcinoma is herein presented in a 77 year-old women. she complained right flank pain and high fever for 3 days, radical nephrectomy was performed and diagnosis was made by H-E stains and immunohistochemical stains of nephrectomy specimen. A brief review about sarcomatoid renal cell carcinoma is made.
Aged ; Carcinoma, Renal Cell* ; Coloring Agents ; Diagnosis ; Female ; Fever ; Flank Pain ; Humans ; Nephrectomy ; Prognosis ; Pyonephrosis*

Spontaneous ureteral rupture is rare, and refers to leakage in the absence of prior ureteral manipulation, external trauma, previous surgery, or any destructive kidney disease. It presents a major diagnostic challenge due to the diversity at presentation. Here, we present a rare case of spontaneous ureteral rupture in a 62-year-old man with a history of fungal pyonephrosis (Candida) on maintenance hemodialysis, causing a large infected urinoma and abscess and a review the literature.
Abscess ; Humans ; Kidney Diseases ; Middle Aged ; Pyonephrosis ; Renal Dialysis ; Rupture ; Ureter ; Urinoma

By using antegrade pyelography which was modified from Casey and Goodwin technique, we examined nine patients in whom accurate roentgenographic diagnosis could not be made by excretory or retrograde pyelography. Diagnosis established were three cases of hydronephrosis due to ureteral calculi, three of pyonephrosis due to renal tuberculosis, one of pyonephrosis due to carcinoma of the ureter, one case of pyonephrosis due to carcinoma of the uretero-pelvic junction and one of pyonephrosis due to ureteral obstruction This is the first report of antegrade pyelography in cases of pyonephrotic renal tuberculosis. No complications occurred during or after examinations. In selected cases of hydronephrosis and pyonephrosis, antegrade pyelography is a safe and new diagnostic procedure to other accepted methods of urography.
Diagnosis ; Humans ; Hydronephrosis ; Pyonephrosis ; Tuberculosis, Renal ; Ureter ; Ureteral Calculi ; Ureteral Obstruction ; Urography*

We reviewed the clinical courses and surgical results of 32 children with ureteropelvic junction obstruction since June, 1985. Major presenting features were abdominal mass and urinary infection in children less then 3 years old and pain was the most frequent presenting symptom in older children. Five children had bilateral involvement. Thirty two pyeloplasties and four nephrectomies were done in 36 renal units. Preoperatively six children had been managed with percutanous nephrostomy due to pyonephrosis, azotemia and marginal renal function. Radiographic and/or functional improvement were recognized in 30 kidneys(94%) In solitary kidney, bilateral involvement, severe infection and redo case, stent and/or nephrostomy applied. Neither stent nor nephrostomy was used in 25 operations and the results were satisfactory in all. Urinary infection might have affected the surgical results inspite of preoperative control. Postoperatively transient urinary leakage developed in 4 children and bacteriuria in 11 but disappeared soon. Excretory urography was performed in all and was enough to diagnose in most patients but in recent period we evaluated the ultrasound study and radioisotope renal scan. We feel these methods are satisfactory in the diagnosis and follow-up of UPJ obstruction and IVP is not always mandatory.
Azotemia ; Bacteriuria ; Child* ; Child, Preschool ; Diagnosis* ; Follow-Up Studies ; Humans ; Kidney ; Nephrectomy ; Pyonephrosis ; Stents ; Ultrasonography ; Urography

We reviewed the clinical courses and surgical results of 32 children with ureteropelvic junction obstruction since June, 1985. Major presenting features were abdominal mass and urinary infection in children less then 3 years old and pain was the most frequent presenting symptom in older children. Five children had bilateral involvement. Thirty two pyeloplasties and four nephrectomies were done in 36 renal units. Preoperatively six children had been managed with percutanous nephrostomy due to pyonephrosis, azotemia and marginal renal function. Radiographic and/or functional improvement were recognized in 30 kidneys(94%) In solitary kidney, bilateral involvement, severe infection and redo case, stent and/or nephrostomy applied. Neither stent nor nephrostomy was used in 25 operations and the results were satisfactory in all. Urinary infection might have affected the surgical results inspite of preoperative control. Postoperatively transient urinary leakage developed in 4 children and bacteriuria in 11 but disappeared soon. Excretory urography was performed in all and was enough to diagnose in most patients but in recent period we evaluated the ultrasound study and radioisotope renal scan. We feel these methods are satisfactory in the diagnosis and follow-up of UPJ obstruction and IVP is not always mandatory.
Azotemia ; Bacteriuria ; Child* ; Child, Preschool ; Diagnosis* ; Follow-Up Studies ; Humans ; Kidney ; Nephrectomy ; Pyonephrosis ; Stents ; Ultrasonography ; Urography