When is surgery indicated in the management of pyelonephritis (kidney infection)?

Updated: Jul 01, 2021
  • Author: Tibor Fulop, MD, PhD, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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In addition to antibiotics, surgery may be necessary to treat the following manifestations of acute pyelonephritis:

  • Renal cortical abscess (renal carbuncle): Surgical drainage (if patients do not respond to antibiotic therapy); other surgical options are enucleation of the carbuncle and nephrectomy
  • Renal corticomedullary abscess: Incision and drainage, nephrectomy
  • Perinephric abscess: Drainage, nephrectomy
  • Calculi-related urinary tract infection (UTI): Extracorporeal shockwave lithotripsy (ESWL) or endoscopic, percutaneous, or open surgery
  • Renal papillary necrosis: CT scan ̶ guided drainage or surgical drainage with debridement
  • Xanthogranulomatous pyelonephritis: Nephrectomy

See Treatment and Medication for more detail.

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