[Emphysematous pyelonephritis. Epidemiological, clinical, biological, bacteriological, radiological, therapeutic and prognostic features. Retrospective study of 30 cases]

Emphysematous pyelonephritis is an uncommon, necrotizing bacterial infection of the kidney. It is a severe, lifethreatening affection. To study the epidemiological, clinical, biological, bacteriological and radiological features of this affection, and to describe its therapeutic management and prognostic characteristics. We conducted a retrospective study including 30 patients who were treated for an emphysematous pyelonephritis, in Charles Nicolle hospital department of urology, from 1987 to 2009. Emphysematous pyelonephritis generally affects adults. It is especially favored by diabetes and urinary tract obstruction. Escherichia coli is the main causative agent. Uroscan is the key of diagnosis. It is both medical and surgical emergency; the treatment combines intensive care with appropriate antibiotics and often drainage. Nephrectomy may be necessary from the outset, or after drainage failure. Prognosis is poor, with a high mortality rate [23%], in our series. Management of emphysematous pyelonephritis poses real problems. This affection is still threatening, despite of advances in intensive care

[Lumboscopic treatment of simple renal cysts]

To assess feasibility and efficiency of lomboscopy in the treatment of simple renal cysts. We report 12 cases of patients presenting symptomatic simple renal cysts treated by lumboscopy from January 2000 to December 2004. The mean age was 57 years [43-72]. They were 11 women and one man. The main revealing sign was pain in each case. A mass was found in 2 cases [16%]. Ultrasonography was realized in all cases. Computed Tomography was realized in 4 cases [33%]. It was a unique cyst in 9 cases [75%], a double cysts in 2 cases [17%] and 4 cysts in 1 case [8%]. The mean size of the cysts was 7.7 cm [5-16]. A parapyelic cyst was found in one case. All the patients were operated through a retroperitoneal approach. Excision of cyst dome was made. The mean operating time was 80 mm [50-160]. No intraoperative complication was noted. The mean hospital stay was 3 days [1-4]. All the cysts were found to be benign histologically. No recurrence is noted with a mean follow-up of 21 months [5-31]. Lumboscopy is a safe and effective technique in the treatment of the symptomatic simple renal cysts with a low rate of complications and recurrence