Technique and place in treatment
After ultrasound marking under local anesthesia, a thin needle is inserted into the perinephric tissue at the lower pole or into the area of maximum edema; 20–40 ml of a broad-spectrum antibiotic solution with novocaine or lidocaine is slowly injected. The needle position is constantly monitored on the screen. The patient notes a decrease in pain within an hour, the temperature decreases in the next 24 hours. The procedure is used in severe cases, when intravenous therapy does not have an effect in the first 48 hours, and there are no indications for drainage; in case of ureteral obstruction, a stent or nephrostomy is simultaneously installed.
Why administer an antibiotic to the kidney?
In acute pyelonephritis with severe swelling of the kidney and perinephric tissue, apostematous pyelonephritis and a developing carbuncle, systemic antibiotics do not always reach the lesion in the required concentration. The introduction of an antibiotic solution with an anesthetic directly into the perinephric tissue creates a high local concentration, relieves spasm and pain (blockade) and accelerates the reverse development of inflammation. The method complements, rather than replaces, intravenous therapy.
Security
The puncture is performed under ultrasound guidance with a thin needle, which eliminates damage to blood vessels and intestines. Contraindications: coagulation disorders and allergies to drugs. If a formed abscess is detected, drainage is performed instead of injection. The procedure is repeated 1-3 times with an interval of 2-3 days according to the dynamics.
