Treatment of pyonephrosis: a comparative study.

Our study is a comparison of treatments used for 97 patients with pyonephrosis. The patients were divided into 3 groups: 1) cases in which a primary nephrectomy was done, 2) cases in which nephrectomy was secondary to drainage through a nephrostomy and 3) cases in which nephrectomy was secondary to drainage through a translumbar percutaneous puncture with an Ingram catheter indwelling. Patients in whom nephrostomy and puncture were used had the highest percentage of complications, while primary nephrectomy produced the best results. Therefore, we believe that primary nephrectomy is the procedure of choice, using drainage through a puncture only when the general status of the patient does not permit primary nephrectomy.