What you need to know about pyelonephritis in men. The course of chronic pyelonephritis in men: treatment, complications Causes of pathology

Pyelonephritis is an inflammatory pathology in which the pyelocaliceal system of the kidneys suffers. The disease often develops in women due to anatomical features structures of the urinary tract. Pyelonephritis in men is rarely confirmed - the male urethra is long and curved, making insertion difficult pathogenic flora into the bladder and kidneys. However, it is not possible to completely exclude the development of pathology in men - there are many other negative factors that provoke inflammation of the PCLS and the bladder. Pyelonephritis develops at any age, but in the group - people over 50-60 years old.

Pyelonephritis in men is always of bacterial origin. When pathogenic microflora enters the system of renal tubules, a purulent-inflammatory process is activated, during which the kidneys and the entire urogenital area are affected. Factors that increase the risk of developing the disease in men:

age over 50;
disorder of metabolic processes;
weakened immune system.

The causative agents of pyelonephritis in men - E. coli, enterobacteria, Klebsiella, staphylococcus - can enter the genitourinary tract if personal hygiene is not observed. But more often inflammation in the kidneys develops as a complication of background diseases:

chronic urological pathologies prostate(prostatitis);
urolithiasis disease;
vesicoureteral reflux;
neoplasms in the urinary tract.

Diseases transmitted through unprotected sexual intercourse (chlamydia, gardnerellosis) can be the starting point for the development of pathology. With genital infections in men, the urethra is affected, urine stagnation occurs with the formation of pus. Through the urethral canal, the infection easily enters the renal parenchyma, causing an acute catarrhal process.

Occasionally, the cause of pyelonephritis in men is secondary foci of infection, localized in other organs - the throat, lungs. With purulent sore throat, carious teeth, inflamed tonsils, pathogenic microorganisms are carried throughout the body with blood flow. When it enters the kidneys, microbes settle on the mucous membrane of the parinchema, forming a secondary infectious focus.

Forms of pathology

The classification of pyelonephritis in men is based on the characteristics of the localization of inflammation, the underlying factor, the phase and intensity of inflammation. Based on the ways in which pathogenic microbes enter the body, pyelonephritis is divided into:

primary - an inflammatory process in the renal system without failures in urodynamics;
secondary - an inflammatory process caused by bacteria entering the genitourinary system, signs of a violation of urodynamics are pronounced; a common cause of secondary pyelonephritis in men is the presence of sand and kidney stones.

Another classification of pathology is based on the features of the clinical picture:

acute pyelonephritis - a type of inflammation with a severe course and purulent lesions of the renal pelvis and tubular system; the symptoms are clearly expressed and cause much suffering to the patient; kidney at acute inflammation swells and increases in volume;
chronic pyelonephritis - a kind of pathology with blurred clinical manifestations, negative symptoms are mild or absent, but the catarrhal process in the kidneys remains; the danger of the chronic form is associated with the risk of progressive renal failure.

Symptoms

With inflammation pelvicalyceal system men develop specific signs:

pain in the lumbar region of a dull or shooting character, which is due to a significant tension of the renal capsule; with pyelonephritis, pain is aggravated by coughing and deep breathing;
rise in temperature to high readings (38.5–40 °), accompanied by chills; a slight decrease in temperature occurs after the act of urination;
discomfort during urination (burning), at the end of the act of urination, a sharp pain appears;
false urge to excrete urine;
nocturia - increased diuresis at night;
change in the appearance of urine - transparency disappears, a cloudy precipitate and a specific smell appear; in the acute phase, blood clots are visible in the urine;
general malaise and state of apathy;
positive symptom of Pasternatsky on one or both sides.

Symptoms of intoxication are typical for pyelonephritis in men, which is associated with the rapid growth of pathogenic microorganisms and diffuse inflammation of the renal parenchyma. Waste products of microbes and toxins enter the bloodstream poisoning the body. Signs of intoxication in pyelonephritis:

weakened state;
headaches up to migraine and dizziness;
bouts of nausea and vomiting;
loss of appetite;
stool disorder.

In the absence of proper treatment, an acute purulent-destructive process in the kidneys flows into chronic stage. Symptoms of chronic pyelonephritis in men:

pains become less pronounced, but become permanent;
the temperature is kept within subfebrile indications (37–37.3 °);
discomfort at the end of the act of urination persists with each emptying of the urea.

In chronic pyelonephritis in men in adulthood, persistent arterial hypertension - excess fluid it is not fully excreted from the body by the kidneys, which leads to edema and increased pressure.

Survey Tactics

If pyelonephritis is suspected, a man should consult a urologist. During the initial treatment, the doctor conducts a conversation on complaints and examines the patient, finds out information about existing diseases of the urogenital area and other somatic pathologies. Valuable information about the presence of acute and latent catarrhal processes in the kidneys is provided by the results of standard laboratory tests- urine and blood.

Urine analysis for pyelonephritis reveals typical signs of inflammation of the renal system:

an increase in the number of leukocytes;
the appearance of fresh erythrocytes over 2 in the field of view;
detection of total protein;
detection of squamous epithelial cells in large quantities;
the presence of Sternheimer-Malbin cells (a reliable sign of pyelonephritis);
an increase in the acidity of the urine.

In the results general analysis blood note the acceleration of ESR, leukocytosis, an increase in the number of stab neutrophils. Blood biochemistry shows an increase in the concentration of creatinine and urea, which is associated with the loss of its functionality by the glomerular apparatus.

Be sure to conduct urine culture from morning urination to identify pathogenic flora. Culture is necessary to determine the sensitivity of bacteria to antibiotics. To clarify the diagnosis, a Zimnitsky test is performed to determine the concentration function of the kidneys.

To confirm pyelonephritis in men, the results of laboratory diagnostics are sufficient, but in certain situations, the examination is supplemented with high-precision instrumental methods:

sonography of the kidneys and retroperitoneal region reveals the presence of kidney edema and the degree of damage to the PCS;
radiography with the introduction of contrast indicates thinning of the renal parenchyma, deformation of the tubular system;
excretory urography is necessary to assess the degree of urodynamic disorder.

Therapeutic measures

In the treatment of pyelonephritis in men, the form of the disease, the intensity of destructive changes in the kidneys, and the type of pathogen are taken into account. Treatment of the disease is organized in 3 directions:

conservative therapy;
surgery (according to indications);
organization of dietary nutrition.

The acute form of pyelonephritis with signs of intoxication and severe pain is an indication for hospitalization. The main goals of treatment are the relief of negative symptoms, the normalization of urination, and the fight against infection. IN stationary conditions if necessary, bladder catheterization is performed. To eliminate pain, drugs with an antispasmodic effect are shown - Drotaverin, Baralgin, Spazmolgon.

Antibiotic therapy is necessary to suppress the focus of infection, the choice of the drug is based on the results of bakposev and detection of the sensitivity of the pathogen to antimicrobial agents. But often, antibiotic therapy is prescribed before the results of a bacterial study on nutrient media are obtained in order to avoid the development of complications.

For the treatment of pyelonephritis in men, antibiotics with an extended spectrum of action are used:

cephalosporins - Ceftriaxone, Cefalotin;
medicines based on clavulanic acid - Augmentin, Flemoklav;
macrolides - Clarithromycin, Azithromycin.

After the subsidence acute phase To prevent relapse, prescribe:

vitamin therapy - taking vitamins of group B, ascorbic acid;
a course of antioxidants - preparations of selenium, tocopherol;
phytopreparations with uroseptic and diuretic effect - Kanefron, Monural.

TO surgical methods treatment of pathology is resorted to in exceptional situations - with a neglected course and a high probability of developing renal failure. Types of operations for pyelonephritis:

kidney decapsulation:
pyelostomy;
nephropyelostomy;
nephrectomy (with an extensive purulent-destructive lesion).

Diet

To speed up recovery along with conservative treatment organize catering. The purpose of the diet for pyelonephritis in men is to minimize the burden on urinary system and support immunity. The optimal nutritional option is a specialized diet number 7. Basic principles:

fractional diet, up to 5 times a day;
the exclusion of dishes rich in extractive substances;
refusal of fried and spicy foods;
salt and protein restriction;
preferred cooking options are boiling, baking, stewing.

ethnoscience

Traditional medicine suggests treating pyelonephritis with the help of herbal medicine. Taking herbal infusions in combination with drug therapy helps to relieve unpleasant symptoms, normalize urination, and remove toxins from the body. Kidney herbal teas can be bought at a pharmacy or prepared independently. Effective folk recipes from pyelonephritis in men:

cornflower decoction - 20 g of meadow cornflower petals pour 250 ml of boiling water, warm over low heat for 15 minutes, after cooling, filter and drink 100 ml twice a day;
yarrow infusion - add a glass of boiling water to 10 g of raw materials, insist 2 hours; the cooled drink is drunk in small portions per day;
oatmeal broth - a liter of boiling water is added to a glass of oats and boiled for 30 minutes, the finished mixture is filtered; drink a mucous decoction of 100 ml up to 4 times a day;
bearberry infusion - 20 g of raw materials are poured into 250 ml of boiling water, insisted in a thermos for 4 hours; take 50 ml three times a day before meals.

Forecast and prevention

With early access to a urologist and adequate therapy, pyelonephritis in men is successfully treated in 2-3 weeks. If left untreated, the acute form of the pathology is complicated by purulent fusion of the renal tissue with the appearance of abscesses. In severe cases, sepsis develops. A formidable complication is renal failure, the likelihood of which increases with bilateral pyelonephritis.

Among all diseases of the urinary system, pyelonephritis is quite common. Both children, and men, and women are ill with it. However, in men, this disease has its own characteristics.

What is pyelonephritis

This disease is an inflammation of the cups and pelvis of the kidney and tissues adjacent to it, which entails a malfunction of the organ. Inflammation of the renal pelvis and its surrounding tissue (parenchyma) occurs simultaneously or alternately, depending on the causes that caused pyelonephritis. Initially, the disease was called "pyelitis" - an inflammatory process in the renal pelvis, but practicing nephrologists abandoned this term, since there is no isolated inflammation in this structure, without the participation of surrounding tissues.

Men suffer from pyelonephritis less often than women due to anatomical and physiological features. Men suffer from inflammation of the kidneys mainly in the elderly or childhood. This is due to the provoking factors of the disease. Elderly men often suffer from prostate adenoma and urolithiasis, which are diseases predisposing to pyelonephritis, and in young children (up to 7 years of age) there is a low resistance of the body to infections.

Disease classification

The disease is classified depending on the clinical course, ways of transmission of infection, localization of the process.

Table - Classification of pyelonephritis

Primary pyelonephritis, which is also called uncomplicated, is not preceded by any pathologies or anomalies in the development of the urinary tract, this type of disease is not associated with a violation of the kidneys or difficulty in the outflow of urine. Secondary (complicated) pyelonephritis develops against the background of functional or organic disorders in the kidneys or urinary tract. Obstructive pyelonephritis characterizes a violation of the outflow of urine from the kidneys or kidneys, with non-obstructive pyelonephritis, the patency of the urinary tract is not impaired.
The most common is secondary (due to other urological diseases) obstructive (with a violation of the outflow of urine due to compression of the upper urinary tract) inflammation of the kidneys. The disease in this form is diagnosed in 85% of cases.
The chronic form of the disease can develop from acute primary pyelonephritis, and also have a secondary origin.

Causes and factors of development in men

The root cause of pyelonephritis is infection. Most often, the causative agents are gram-negative microorganisms (90% of all pyelonephritis), of which in half of the cases - Escherichia coli. In addition to it, the cause of inflammation can be staphylococci, streptococci, as well as viruses, fungi, mycoplasma. Pathogens can enter the kidney by the hematogenous route, that is, with the help of blood from various sources of infection in the body, for example, carious teeth, sore throat, boils, etc. If there are favorable conditions for the reproduction of bacteria in the kidney, such as impaired blood circulation or lymph circulation in the parenchyma or stagnation of urine in the pelvis and urinary tract, then the inflammatory process begins.

The second way of penetration of microorganisms into the kidney is ascending. In this case, urine, already infected with microbes, enters the kidney structures. This phenomenon can occur in the case of reverse reflux of urine, that is, reflux. Most often, reflux occurs at the level of the bladder - the ureters. In addition, the outflow of urine may be disturbed due to various congenital anomalies structures of the kidneys, ureters, kidney stones, strictures (narrowing) of the ureters, prolapse of the kidneys. All these pathologies contribute to the stagnation of urine and the reproduction of microorganisms in it.
The provoking factors of the disease in men are the following:

old age;
kidney stones - urolithiasis;
stricture (narrowing) of the urethra;
prostatitis and prostate adenoma;
STDs - sexually transmitted diseases;
diabetes;
urological studies - cystoscopy, urography, catheterization.

In young men, pyelonephritis is most often associated with urolithiasis, in older men - with chronic inflammation prostate or adenoma. As a result of these diseases, squeezing of the ureter by an enlarged gland or a violation of the patency of urine due to a stone in the kidney or ureter occurs. Stagnation of urine contributes to a decrease in local immunity and provokes the reproduction of pathogenic microbes. The same thing happens with the narrowing of the urethra, which can occur due to trauma, various inflammations or congenital anomalies.
Sexually transmitted diseases cannot cause pyelonephritis directly, but they contribute to a decrease in the protective properties of the mucous membranes and the spread of the infectious process to other parts of the urinary tract.
Diabetes mellitus causes circulatory disorders in body tissues, reduces the ability to heal, thereby also provokes the development of inflammation in the kidneys.

Chronic pyelonephritis most often occurs as a complication of acute. The recurrence of the disease is facilitated by the general cooling of the body, increased physical exercise, nervous exhaustion, impaired urodynamics.

It has been proven that the development of chronic pyelonephritis is facilitated by the characteristics of the immune system and genetic predisposition.

A feature of inflammation of the kidneys in men is the recurrent course of the disease, which is associated with the anatomical feature of the urinary tract - the ureter is surrounded by the prostate gland.

Symptoms and signs of acute and chronic forms of the disease

Main features inflammatory process in the kidneys:

Dysuric phenomena;
Pain syndrome;
Fever;
Symptoms of intoxication.

All these manifestations can be of different intensity or completely absent, depending on the causes that caused the inflammation, on the nature, form of the disease, and comorbidities.

Dysuric phenomena are special group symptoms that characterize a violation of the normal process of urine excretion:

frequent urination;
imperative (false) urges - the desire to empty the bladder when it is almost empty;
nocturia - frequent urination at night;
pain, cramps, burning in the process of emptying the bladder.

Pain syndrome can be of a different nature. The pain is dull, aching, constant in the lumbar region, in the lower abdomen. If a purulent process begins to develop, the pain increases significantly. It can acquire an intense, sharp, stabbing character - these are signs renal colic. Such pain occurs when the lumen of the urinary tract is blocked with a mucous plug or calculus in case of urolithiasis, which often acts as a provoking factor in pyelonephritis.

In an acute course or exacerbation of a chronic process, a high temperature rises. It rises to critical figures when purulent formations in the kidney - an abscess or carbuncle.
Intoxication of the body is manifested by a general deterioration in the condition, lack of appetite, nausea, vomiting, weakness, headaches, muscle, joint pain.

Spicy

Clinical manifestations of an acute process are directly related to the stage of the disease, comorbidities, existing complications, the age of the patient, immunity, and the general condition of the body.
The first stage is serous pyelonephritis, the duration of this period can vary from 6 hours to 2 days. Then purulent destruction begins in the kidney.

Table - changes in the kidneys

stages	What happens to the diseased body
Serous pyelonephritis	Formation of multiple inflammatory infiltrates in the parenchyma, the kidney is swollen, tense, enlarged.
Apostematous pyelonephritis	Many small purulent foci appear in the upper layer of the kidney and in brain matter.
Carbuncle	It is formed as a result of the fusion of abscesses or blockage by a microbial embolus renal artery.
Abscess	It is characterized by purulent destruction of the renal tissue. The formed focus can break into the tissues surrounding the kidney and cause severe complications in the form of purulent paranephritis or phlegmon.
Necrotizing papillitis or papillary necrosis	Destruction of the medulla of the kidney, damage to the renal papillae leads to to serious disturbances in the work of the body.

Destructive, purulent-ischemic forms of pyelonephritis occur mainly with obstruction of the upper urinary structures.

Clinical picture acute pyelonephritis:

The disease begins with acute, paroxysmal pain in the lumbar region, which intensifies with pressure, movement, and a change in body position.
The temperature rises to 38-40 degrees, severe chills, intense sweating.
Intoxication is manifested by nausea, lethargy, loss of strength, dizziness, headache, severe thirst, tachycardia (increased heartbeat).
The amount of urine decreases sharply, it is most often cloudy, but may remain transparent if the ureter is clogged with a serous plug or stone.
The muscles in the lumbar region are rigid (tense), you can feel an enlarged and very painful kidney.

Accession of purulent destruction aggravates clinical symptoms. The pain becomes constant, hectic fever and tremendous chills join.

Hectic fever is characteristic of septic conditions and is a significant sharp drops and rises in temperature at intervals of several hours.

The muscles of the lower back and abdomen are sharply tense, the kidney or both kidneys are very painful. General state the patient worsens, dehydration joins, the skin is very pale, facial features become pointed. Arterial pressure is lowered. The patient is forced to take an uncomfortable position in order to alleviate the pain a little.

The clinic of primary acute pyelonephritis without obstruction differs significantly from secondary pyelonephritis.
In the first case, the leading role is played by common features body intoxication, local symptoms(pain, dysuria) may not be present at all. This feature often leads to errors in the correct diagnosis. The clinical picture develops quickly - from a couple of hours to one day. Characterized by a general loss of strength, malaise, the temperature rises to very high numbers - 39-40 degrees, the patient sweats a lot, he is shivering, he complains of headaches, joint and muscle pain, nausea. The pulse is weak and frequent, the tongue is dry, the patient is very thirsty. Vomiting or diarrhea is possible.
Secondary acute pyelonephritis usually begins with renal colic. At the same time or immediately after it, the temperature rises sharply to 39–41 degrees, symptoms of intoxication join. A short-term increase in temperature is replaced by an imaginary improvement - it begins to decrease to normal, the patient feels better, the pain decreases. However, if the root cause of urinary tract obstruction is not eliminated, then after a while (from several hours to 1-2 days) the symptoms return - the pain intensifies, the temperature rises again, chills and deterioration of health begin again.
Symptoms of acute inflammation of the kidneys in different people may differ.

Chronic pyelonephritis

In the chronic course of the disease, inflammation first captures individual parts of the kidney, then the entire organ is deformed, the parenchyma is replaced by connective tissue, which leads to wrinkling of the kidney.

Chronic pyelonephritis can be latent and have relapses.

In the phase of active inflammation, there are symptoms that are no different from acute pyelonephritis. Sometimes exacerbation proceeds without bright clinical symptoms, only dysuric syndrome may be present.
The phase of latent inflammation manifests itself as mild symptoms or does not manifest itself at all. The main signs of this phase are the symptoms of chronic intoxication: loss of strength, headache, lethargy, subfebrile temperature. More significant symptoms are pain in lumbar or in the lower abdomen, often aching in nature, as well as dysuric phenomena. Persistent arterial hypertension is formed, later edema forms, most often under the eyes, and can also appear on the legs. Edema occurs after sleep, in the morning, they are soft, symmetrical.
The remission phase does not manifest itself as any painful symptoms.

Diagnosis of the disease

A thorough examination of the patient makes it possible to distinguish pyelonephritis from pathologies with similar manifestations:

acute infections - meningococcal, typhoid;
pathologies of the digestive system, which are characterized by an acute abdomen:
- ulcer of the stomach and duodenum;
- an attack of acute inflammation gallbladder, pancreas;
- appendicitis;
tuberculosis of the kidneys;
glomerulonephritis;
cyst or tumor of the kidney.

Since the clinical manifestations of inflammation of the kidneys are very extensive, a laboratory and hardware examination of the patient, as well as a thorough history taking, plays an important role in making a diagnosis.

Anamnesis

In the diagnosis of secondary pyelonephritis, provoking urological diseases are taken into account - urolithiasis, prostatitis, urethral stenosis.

Patient examination

The patient has a characteristic appearance - pale, moist skin, dry, furred tongue, he has tachycardia, low arterial pressure. When probing, the doctor determines a sharp soreness of the enlarged kidney, muscle tension in the lower back and anterior abdominal wall. Pasternatsky's symptom is positive - with a slight tapping on the patient's lower back, the pain intensifies, after which erythrocytouria appears or increases for a short time (erythrocytes in the urine).

Laboratory examination

Clinical analysis of urine shows:

increased level of leukocytes;
the number of bacteria is more than 100 thousand in 1 ml;
low density;
Ph shift to the alkaline side (normal urine is acidic);
protein in the urine.

Urinalysis according to Nechiporenko (research cell sediment in 1 ml of urine):

elevated leukocytes (normal up to 2 thousand per ml);
elevated red blood cells (normal up to 1 thousand per ml);
the presence of cylinders (normally absent).

Urinalysis according to Zimnitsky is prescribed to determine the functionality of the kidneys. To do this, daily urine is collected, every 3 hours a new portion in a separate container.
Urine culture is used to identify the pathogen and the correct selection of the antibiotic.

Hardware and instrumental examination

Hardware examination of the patient gives the doctor the most complete picture of the disease.

To make a diagnosis, an ultrasound of the kidneys is performed first. Using this method, the shape, size of the kidneys, the deformation of the renal structures, the presence and location of calculi or tumor formations are determined.
Extended information about the state of the urinary system gives excretory urography. It allows you to study in more detail the structure and work of the renal pelvis, ureters, allows you to detect stones that are invisible during other examinations. Urography makes it possible to detect anomalies in the development of the urinary system, deviations in the work of the ureters and cups, and also to determine the degree of their patency.
CT ( CT scan) allows you to determine the degree of damage to the parenchyma and detect complications.
Examination methods using an endoscope - chromocystoscopy, cystoscopy are used to detect abnormalities in the work of a diseased kidney. The method is rarely used, in order to confirm the diagnosis or, if necessary, catheterization of the ureter for therapeutic measures.
Radioisotope methods - renography and scanogram - are additional to radiography and help to determine violations of the structure and functioning of the diseased organ.

Treatment of pyelonephritis

Therapeutic tactics is determined by the pathogenesis and clinic of the disease.
Patients with an acute form are hospitalized. The treatment is complex and consists of bed rest, sparing diet, antimicrobial, detoxification, immunomodulatory therapy, and measures are taken to eliminate urinary tract obstruction.
The duration of bed rest is determined by the condition of the patient. Any physical and mental stress is excluded.

Medical therapy

The doctor may prescribe antibiotics from different groups:

Penicillin group: Augmentin, Amoxicillin, Oxacillin;
Cephalosporin: Ceftriaxone, Cephalexin, Cefuroxime;
Fluoroquinolones: Ofloxacin, Norfloxacin, Levofloxacin, Ciprofloxacin;
Aminoglycasides: Gentamicin, Tobramycin;
Tetracycline group: Doxycycline.

In some cases, combined antibiotic therapy is used. Antibiotics are prescribed for at least 14 days, sometimes up to 4-6 weeks. With such long term the use of antibacterial drugs necessarily prescribe antifungal agents, vitamins and antihistamines.
In addition to antibiotics, prescribe:

sulfonamides (Urosulfan, Bactrim, Groseptol);
nitrofurans (Furagin, Furomag, Furodonin);
quinolones (Nitroxoline).

These drugs are used to treat mild, uncomplicated forms of the disease or intolerance to antibiotics.

Diuretics in small doses are prescribed for chronic pyelonephritis.
Immunomodulators increase the body's resistance and prevent exacerbations of a chronic process: Timalin, T-activin.
Non-steroidal anti-inflammatory drugs are prescribed to relieve inflammation: Nimesulide, Voltaren.
Drugs to improve renal blood flow: Curantil.
In severe cases, with bacterial shock, Hydrocortisone, Prednisolone is used.
To eliminate intoxication, the patient is injected with a large amount of fluid intravenously: glucose solution, Hemodez, saline, Reopoliglyukin.
In case of violations of urodynamics, urgent catheterization of the upper urinary tract is performed. If through catheterization it is not possible to remove the obstacle that impedes the outflow of urine, then the patient undergoes an operation - decapsulation of the kidney, pyelostomy or nephrostomy (drainage of the renal pelvis).

Surgical intervention is required when the progression of purulent destructive forms: choose organ-preserving operations, during which decapsulation of the kidney, dissection of the purulent focus and drainage of its cavity, as well as the pelvis, are performed. In severe clinical course and the development of urosepsis, the diseased kidney is removed - the operation is called nephrectomy.

Diet food

Therapeutic diet plays an important role in the recovery of the patient.
The diet should contain the optimal amount of nutrients, proteins, vitamins, be easily digestible, exclude foods that can irritate the urinary system, and also limit the amount of salt. IN acute period the table is preferably vegetarian: dairy and dairy products, steamed cereals, mashed vegetables and fruits, unsalted bread. As the symptoms ease, the patient needs to add lean fish, boiled or steamed lean meat, eggs to the diet, and expand the range of dairy dishes.
For the entire period of illness, spicy, fatty foods, any canned food, marinades and pickles, strong broths, coffee, hot spices, alcohol, coarse vegetables - onions, hot peppers, horseradish, garlic are prohibited.
The patient needs to consume a lot of fluid: a total of 2.5 - 3 liters, including parenteral solutions. Drinking is better to use in the form of tea, fruit juices, decoction and infusion of wild rose, fruit decoctions, kissels, mineral waters as prescribed by a doctor.

Cranberry juice is very useful, especially when high temperature. The drink contains a lot of sodium benzoate, which turns into hippuric acid, splitting by liver enzymes. Passing through the kidneys, this acid has a bactericidal effect on the local microflora and enhances the action of antibiotics.

Phytotherapy

Reception of herbal decoctions and infusions is allowed only as directed and under the supervision of a physician.
A decoction of stinging nettle, an infusion of budra leaves, plantain juice, birch, cranberry juice, a decoction of bearberry, strawberries, lingonberries, kidney collections with a diuretic and anti-inflammatory effect are recommended.

Physiotherapy methods

Physiotherapy helps to remove the inflammatory process, eliminate spasms, restore the normal process of urine outflow.
Contraindications for physiotherapy procedures:

acute pyelonephritis in the active phase;
advanced chronic form of the disease;
hydronephrosis;
kidney cyst.

Physiotherapeutic measures for pyelonephritis:

therapeutic baths;
ultrahigh-frequency and superhigh-frequency therapy (not prescribed for urolithiasis);
magnetotherapy;
ultrasound;
laser therapy;
amplipulse therapy;
electrophoresis with antimicrobial drugs.

Usually the patient is assigned a complex of three different procedures.

In the remission phase, patients with chronic pyelonephritis are referred to spa treatment V Mineral water, Truskavets, Karlovy Vary, Pyatigorsk.

Video - Pyelonephritis and its treatment

Prognosis, complications, consequences of the disease

Acute inflammation most often ends in recovery. Complications of acute pyelonephritis:

the most formidable is bacteriotoxic shock;
kidney carbuncle;
pyonephrosis - filling with purulent exudate of all renal structures;
perinephritis - a purulent process captures the fibrous renal capsule;
paranephritis - pus penetrates into the perirenal tissue;
papillonekrosis - destruction of the renal papillae;
sepsis;
chronic kidney abscess.

Sepsis, bacteriotoxic shock, pyonephrosis and papillary necrosis can cause the patient's death.

A chronic form of inflammation of the kidneys can threaten the development of persistent nephrogenic arterial hypertension, the consequence of which can be a stroke, myocardial infarction. A protracted chronic course often leads to wrinkling of the kidney, which causes chronic renal failure, if the process is bilateral.

Prevention

To prevent the development of the disease, it is necessary:

timely eliminate foci of infection in the body;
do not disregard and treat urological diseases;
drink plenty of fluids to ensure normal urodynamics;
avoid hypothermia;
observe personal hygiene;
lead correct image life, eat rationally, strengthen the immune system.

Pyelonephritis is a disease that requires mandatory treatment. Despite the fact that men suffer from pyelonephritis less often than women, the complications of this disease are no less serious. Timely treatment can save lives and preserve health.

Severe inflammatory disease of the urinary organs - pyelonephritis, which has become chronic.

Pyelonephritis has traditionally been considered a female pathology, modern studies have shown that men suffer from the disease no less, especially in old age.

Chronic pyelonephritis in men, the treatment of which has not been completed, continues to affect the renal tubules latently, without causing specific signs of pathology.

Causes of the appearance of pathology

Pyelonephritis is provoked by several reasons. The least common is the penetration of infection into the urinary organs.

In men, the ascending path of infection does not lead to pyelonephritis - the disease is detected much earlier, and the necessary measures are taken.

More often occurs:

due to stagnation of urine, which is often observed in men of mature and advanced age;
due to the reverse flow of urine - vesicoureteral reflux;
in violation of the blood supply to the kidney or lymph flow.

If these pathologies are not treated, it occurs. Inflammation of the renal pelvis in a chronic form is the result of a complication of diagnosed pathologies - urolithiasis, chronic prostatitis, tumor neoplasms of organs genitourinary system, BPH.

Chronic pyelonephritis sometimes becomes a consequence of unsuccessful catheterization if the rules for the procedure are not followed, and in urinary tract got an infection. The disease is provoked by the hematogenous route, if pathogenic microorganisms enter the kidneys with the blood stream. Becomes a consequence of angina.

Symptoms of the disease

Signs of the chronic type do not appear while the disease is in remission. Occasionally, unpleasant pulling pains in the lower back are felt, aggravated by lifting weights or coughing.

Interestingly, the pain occurs on the side of the healthy kidney. Tension in the back and discomfort appear after standing for a long time, aggravated by walking, but men do not associate such sensations with pyelonephritis, but consider these problems with the spine.

Acts of urination do not cause problems. In patients, appetite worsens, the temperature ranges from normal to subfebrile.

With the manifestation of the disease, when relapses occur, men suffer from severe symptoms. When the kidney stones move, the temperature rises, hematuria occurs.

The state of health worsens - fatigue, lethargy, headaches are observed. The pressure rises, and at night, patients often go to empty the bladder. In the morning, swelling of the face is noticed, by the evening hands and feet swell.

Diagnosis of the disease

It is difficult to diagnose chronic pyelonephritis if the disease occurs against the background of a pathology that lubricates the symptoms of pyelonephritis.

For example, the symptoms of urolithiasis or tuberculosis come first, but the signs of chronic pyelonephritis are masked and detected only by laboratory tests.

Treatment of pathology

Chronic pyelonephritis is a consequence of undertreated. Fighting the chronic form is harder negative impact on the kidneys provokes disruption of the renal tubules, degenerative changes in the renal parenchyma. As a result of irreversible changes, the kidneys stop excreting urine.

Chronic pyelonephritis is treated with antibacterial and anti-inflammatory drugs. In the presence of a specific pathogen, drugs that are minimally toxic to the kidneys are prescribed. Before starting treatment, it is recommended to do a bacterial culture of urine to determine the pathogen. This will allow you to choose drugs that are effective for therapy.

Among antibacterial agents penicillins and cephalosporins, fluoroquinolones, sulfonamides are prescribed. With a wide spectrum of action "Amoxicillin", "Azlocillin".

From the group of cephalosporins, Cedex and are considered effective. From the fluoroquinolone group, Levofloxacin, Ofloxacin, Ciprofloxacin, Norfloxacin are recommended - they are effective against most representatives of pathogenic microflora.

They take "Furamag" or "Furadonin", "Nitroxoline", but the sensitivity to them has decreased. To monitor treatment, a urine test is done every ten days - this will help demonstrate the dynamics of the disease.

If pyelonephritis is nonspecific and caused by concomitant pathologies, then the cause of the disease is eliminated. Men cure prostate adenoma, chronic prostatitis, crush stones.

For the treatment of the disease, stays in resorts are useful. A pronounced positive effect on the urinary organs in men has water from the springs of Truskavets, Karlovy Vary, Zheleznovodsk.

Complications of the disease

The disease is primarily dangerous complications. Since the disease progresses slowly, pathological changes develop in stages, but are fully manifested at the stage of manifestation, or as an independent pathology.

The disease provokes:

nephrosclerosis - wrinkling of the parenchyma of the kidney, growth connective tissue;
pyonephrosis - purulent fusion of the kidney with the formation of an abscess;
pedunculitis - an inflammatory change in the fiber in the region of the kidney gate, accompanied by necrotic changes;
necrotic papillitis - necrosis of the renal papillae.

As a result of these complications, the kidney loses its ability to produce urine, and doctors diagnose organ failure.

Such a complication appears suddenly - in patients, the excretion of urine stops, swelling begins; if urine comes out in small portions, and blood is present.

Patients' health deteriorates sharply - a breakdown develops, drowsiness develops, blood pressure rises, pains begin in the lumbar region and back.

Then symptoms of intoxication appear - nausea and vomiting, skin itching, loss of consciousness, doctors diagnose a precoma.

In this case, assistance is provided in the first six hours after the first signs appear. The man is hospitalized urgently, preferably in the nephrology department, where a nephrectomy will be performed - an operation to remove the affected kidney.

Life with one kidney is possible, but it imposes (compliance with the drinking regime) and pastime (refusal of power sports, transition to light work) for such patients.

Video

Symptoms and treatment of pyelonephritis in men directly depend on the course, severity of the disease, and the presence of concomitant pathologies. Often, patients are negligent about their own health and do not fully understand what consequences such indifference can lead to.

Disease classification

According to ICD 10, pyelonephritis belongs to the group of tubulointerstitial kidney damage. As in any other pathology, there are two clinical forms, differing in symptoms and development:

acute;
chronic.

Chronic pyelonephritis is further divided into three subtypes:

recurrent - includes stages of remission and exacerbation;
latent - sluggish pathological process in which there are no symptoms;
pyelonephric wrinkled kidney - pathomorphological changes in the organ, accompanied by a violation of the functional activity of the urinary system.

By localization, inflammation of the parenchyma can be:

focal;
common;
unilateral;
bilateral.

The latter form is considered the most severe, since the blood filtration process is completely disrupted, and the likelihood of developing acute or chronic renal failure increases significantly.

Causes and development factors

Pyelonephritis is a disease that appears solely due to opportunistic or pathogenic microflora. The pathogens are the microorganisms described in the table below.

IMPORTANT! When a bacterium is detected Special attention is given to L-forms - cells that lack a dense polysaccharide wall, but have not lost the ability to develop. It is these microorganisms that lead to the chronic course of inflammation.

Factors contributing to the formation of pyelonephritis in men include:

decrease in the immune forces of the body;
malnutrition;
passive lifestyle;
elderly age;
endocrine disorders (diabetes mellitus);
bad habits (smoking, drug addiction, alcoholism);
inappropriate use of antibacterial drugs;
concomitant diseases of the urinary system (cystitis).

The spread of the infection is ascending path, that is, from urethra through the bladder and ureters to the renal parenchyma.

The clinical picture is variable, the acute and chronic forms have nuances that should be taken into account when prescribing diagnosis and treatment.

In the active phase of pyelonephritis, the patient can confidently name the time when the state of health worsened. It is characterized by the following symptoms:

a sharp increase in temperature to 39-40 degrees;
weakness;
headache;
chills;
excessive sweating skin;
nausea, vomiting (rare);
pain in the lumbar region: acute or dull, aching, constant;
decrease in volume and change in color of urine;
increased heart rate;
arterial hypertension.

Chronic inflammation is different, including features such as:

temperature up to 37.5;
malaise;
increased fatigue;
periodic aching pain in the lower back;
loss of appetite;
gradually increasing arterial hypertension.

As pathomorphological changes in tissues progress, men develop renal failure, which has a slightly different clinical picture.

How is pyelonephritis diagnosed in men

To confirm the development of the disease in a patient, the doctor must rely on a number of data obtained during the examination, questioning, laboratory and instrumental studies.

Survey

The doctor first of all recognizes the complaints of a man who bother him. The specialist pays attention to the nature of pain, the duration of symptoms and diuresis.

Next, the medical history is collected. The presence of such early signs, concomitant pathologies of the genitourinary system in the form of cystitis or STDs is specified. Of interest is heredity, lifestyle, in particular, diet and the presence of bad habits.

Inspection

The urologist or therapist, after collecting the necessary information, asks the man to undress to the waist for further examination. Using a phonendoscope, the lungs and heart are listened to, blood pressure is measured with a tonometer, and the abdomen is palpated.

To identify and differentiate the pathology of the urinary system, the doctor must check the symptom of Pasternatsky or the symptom of tapping, in which there is an increase in soreness of the kidneys with light tapping on the right and left parts of the lower back.

Laboratory research

Enough informative method diagnosis is considered a general urine test. It notes:

leukocyturia - the appearance of leukocytes in the biological fluid;
pyuria - the formation and release of pus;
erythrocyturia - the presence of red blood cells in the urine.

Bacteriological culture is possible, which allows to identify the pathogen and its sensitivity to antibiotics. In practice, it is not always used, since it requires waiting for results within five days, and treatment is prescribed immediately after the disease is detected.

in general and biochemical analysis blood, the erythrocyte sedimentation rate increases, the concentration of leukocytes, transaminases, urea and creatinine increases.

Instrumental diagnostics

In order to visualize the urinary system, to determine its structural disorders, modern technical methods are needed. The data obtained during the different types of surveys are presented below.

Diagnostics	Conclusion
ultrasound	On initial stages pyelonephritis: an increase in the size of the organ, a decrease in its mobility during breathing.
	In the formation of an abscess: the presence of a hypoechoic area that does not have a clear contour
	In the later stages: a decrease in the size of the kidney, "wrinkling" of the organ.
Radiography with contrast	An increase or decrease in the size of the organ, edema of the perinephric tissue, a decrease in the excretory function.
Magnetic resonance or computed tomography	The change in the size of the kidney, the presence or absence of purulent masses, structural disorders of the pyelocaliceal system are specified.

Ultrasound examination is the most acceptable, as it has no contraindications, does not provide additional negative impact on the body of a man and is available in all medical institutions.

Prognosis and complications

The outcome of the disease is variable timely diagnosis and treatment pathology ends with recovery. Chronization of the process is possible in 20-30% of cases.

As complications of pyelonephritis are:

infectious-toxic shock;
infertility;
acute or chronic renal failure;
carbuncle, kidney abscess;
purulent paranephritis;
sepsis;
malignant arterial hypertension.

The lethal outcome is recorded most often with the appearance or infectious-toxic shock.

Treatment

Therapy begins immediately, the patient is hospitalized, he is prescribed a diet, etiotropic and symptomatic drugs. In severe cases, surgery is indicated.

Restoration of the outflow of urine

Since with pyelonephritis there is a decrease in diuresis, as well as intoxication of the body, doctors prescribe intravenous drip introduction solutions such as:

sodium chloride;
potassium chloride;
calcium chloride;
sodium acetate;
glucose 5 or 10%.

The patient in the form of tablets is prescribed diuretics - diuretic drugs. The most common is Furosemide, Spironalactone, Diacarb.

Antibiotics for pyelonephritis

Treatment is based on the use of antibiotics. medicines. The drugs of choice are:

cephalosporins of the second or third generation (Ceftriaxone);
fluoroquinolones (ciprofloxacin);
protected penicillins (Amoxiclav).

Aminoglycosides are prescribed only if the microorganism has no sensitivity to other antibiotics or the patient has symptoms allergic reaction for the listed drugs.

IMPORTANT! It is forbidden to self-medicate, complications may develop.

Symptomatic drugs

To temporarily improve the patient's condition, reduce the severity of signs of pyelonephritis in men at the beginning of therapy, the doctor prescribes a number of additional medicines. These include:

anti-inflammatory, antipyretic drugs: Paracetamol, Nimesil;
antispasmodics: Papaverine, Drotaverine;
medicines that lower blood pressure: Captopril, Losartan.

If the symptoms of intoxication are pronounced, the clinic is supplemented by vomiting, Cerucal is administered intramuscularly.

Physiotherapy

This method of treatment is indicated only for the rehabilitation of the patient after. It is forbidden to carry out procedures under the following conditions:

active phase of the disease;
advanced chronic form;
hydronephrosis in the stage of decompensation;
polycystic kidney disease.

For the speedy restoration of the urinary system, such areas of physiotherapy are used as:

amplipulse therapy;
taking therapeutic baths with mineralized water;
magnetotherapy;
ultrasound;
laser;
electrophoresis with antibacterial agents;
Microwave, UHF.

Which method is necessary for a man, the attending physician decides. According to the recommendations, the doctor should prescribe no more than three types of wellness procedures.

Folk methods

The most popular are infusions of harlay, birch, cranberry juice, tea with the addition of hibiscus, as well as decoctions of bearberry.

IMPORTANT! It is not necessary to build therapeutic tactics exclusively on alternative methods of treatment, since not a single remedy made at home is able to fully restore kidney function and destroy the infection.

Surgery

Surgery is resorted to in the most extreme cases, when conservative therapy does not give results, and the patient's condition is rapidly deteriorating. In this case, there are four types surgical intervention:

organ decapsulation;
pyelostomy;
nephropyelostopia;
nephrectomy.

The last type involves the complete removal of the kidney. Such a radical method prevents the development of sepsis, infectious-toxic shock, as well as the formation of retroperitoneal phlegmon.

Preventive measures

Specific prevention does not exist. To prevent the development of this pathology, it is necessary to follow several elementary recommendations:

observe the rules of personal hygiene;
lead a healthy lifestyle;
Healthy food;
timely treat diseases not only of the genitourinary system, but also of other organs.

Men should refrain from casual sexual intercourse, as the pathogens of gonorrhea, syphilis, chlamydia can also cause inflammation of the renal parenchyma.

In contact with

Classmates

Pyelonephritis is an inflammatory pathology in which the pyelocaliceal system of the kidneys suffers. The disease often develops in women due to the anatomical features of the structure of the organs of the urogenital area. Pyelonephritis in men is rarely confirmed - the male urethra is long and curved, which makes it difficult for the pathogenic flora to enter the bladder and kidneys. However, it is not possible to completely exclude the development of pathology in men - there are many other negative factors that provoke inflammation of the PCLS and the bladder. Pyelonephritis develops at any age, but in the group - people over 50-60 years old.

age over 50;
disorder of metabolic processes;
weakened immune system.

chronic urological pathologies of the prostate gland (prostatitis);
urolithiasis disease;
vesicoureteral reflux;
neoplasms in the urinary tract.

Forms of pathology

primary - an inflammatory process in the renal system without failures in urodynamics;
secondary - an inflammatory process caused by bacteria entering the genitourinary system, signs of a violation of urodynamics are pronounced; a common cause of secondary pyelonephritis in men is the presence of sand and kidney stones.

Another classification of pathology is based on the features of the clinical picture:

acute pyelonephritis - a type of inflammation with a severe course and purulent lesions of the renal pelvis and tubular system; the symptoms are clearly expressed and cause much suffering to the patient; the kidney with acute inflammation swells and increases in volume;
chronic pyelonephritis - a kind of pathology with blurred clinical manifestations, negative symptoms are mild or absent, but the catarrhal process in the kidneys remains; the danger of the chronic form is associated with the risk of progressive renal failure.

With inflammation of the pyelocaliceal system in men, specific signs develop:

pain in the lumbar region of a dull or shooting character, which is due to a significant tension of the renal capsule; with pyelonephritis, pain is aggravated by coughing and deep breathing;
rise in temperature to high readings (38.5–40 °), accompanied by chills; a slight decrease in temperature occurs after the act of urination;
discomfort during urination (burning), at the end of the act of urination, a sharp pain appears;
false urge to excrete urine;
nocturia - increased diuresis at night;
change in the appearance of urine - transparency disappears, a cloudy precipitate and a specific smell appear; in the acute phase, blood clots are visible in the urine;
general malaise and state of apathy;
positive symptom of Pasternatsky on one or both sides.

Symptoms of intoxication are typical for pyelonephritis in men, which is associated with the rapid growth of pathogenic microorganisms and diffuse inflammation of the renal parenchyma. Waste products of microbes and toxins enter the bloodstream, poisoning the body. Signs of intoxication in pyelonephritis:

weakened state;
headaches up to migraine and dizziness;
bouts of nausea and vomiting;
loss of appetite;
stool disorder.

In the absence of proper treatment, the acute purulent-destructive process in the kidneys flows into the chronic stage. Symptoms of chronic pyelonephritis in men:

pains become less pronounced, but become permanent;
the temperature is kept within subfebrile indications (37–37.3 °);
discomfort at the end of the act of urination persists with each emptying of the urea.

In chronic pyelonephritis in men in adulthood, persistent arterial hypertension often develops - excess fluid is not excreted from the body by the kidneys in full, which leads to edema and increased pressure.

Survey Tactics

Urine analysis for pyelonephritis reveals typical signs of inflammation of the renal system:

an increase in the number of leukocytes;
the appearance of fresh erythrocytes over 2 in the field of view;
detection of total protein;
detection of squamous epithelial cells in large quantities;
the presence of Sternheimer-Malbin cells (a reliable sign of pyelonephritis);
an increase in the acidity of the urine.

In the results of a general blood test, an acceleration of ESR, leukocytosis, and an increase in the number of stab neutrophils are noted. Blood biochemistry shows an increase in the concentration of creatinine and urea, which is associated with the loss of its functionality by the glomerular apparatus.

To confirm pyelonephritis in men, the results of laboratory diagnostics are sufficient, but in certain situations, the examination is supplemented with high-precision instrumental methods:

sonography of the kidneys and retroperitoneal region reveals the presence of kidney edema and the degree of damage to the PCS;
radiography with the introduction of contrast indicates thinning of the renal parenchyma, deformation of the tubular system;
excretory urography is necessary to assess the degree of urodynamic disorder.

Therapeutic measures

conservative therapy;
surgery (according to indications);
organization of dietary nutrition.

The acute form of pyelonephritis with signs of intoxication and severe pain is an indication for hospitalization. The main goals of treatment are the relief of negative symptoms, the normalization of urination, and the fight against infection. In stationary conditions, if necessary, bladder catheterization is performed. To eliminate pain, drugs with an antispasmodic effect are shown - Drotaverin, Baralgin, Spazmolgon.

For the treatment of pyelonephritis in men, antibiotics with an extended spectrum of action are used:

cephalosporins - Ceftriaxone, Cefalotin;
medicines based on clavulanic acid - Augmentin, Flemoklav;
macrolides - Clarithromycin, Azithromycin.

After the acute phase subsides, to prevent relapse, the following is prescribed:

vitamin therapy - taking vitamins of group B, ascorbic acid;
a course of antioxidants - preparations of selenium, tocopherol;
phytopreparations with uroseptic and diuretic effect - Kanefron, Monural.

Surgical methods of treating pathology are resorted to in exceptional situations - with a neglected course and a high probability of developing renal failure. Types of operations for pyelonephritis:

kidney decapsulation:
pyelostomy;
nephropyelostomy;
nephrectomy (with an extensive purulent-destructive lesion).

To speed up recovery, along with conservative treatment, dietary nutrition is organized. The purpose of the diet for pyelonephritis in men is to minimize the burden on the urinary system and support the immune system. The optimal nutritional option is a specialized diet number 7. Basic principles:

fractional diet, up to 5 times a day;
the exclusion of dishes rich in extractive substances;
refusal of fried and spicy foods;
salt and protein restriction;
preferred cooking options are boiling, baking, stewing.

ethnoscience

cornflower decoction - 20 g of meadow cornflower petals pour 250 ml of boiling water, warm over low heat for 15 minutes, after cooling, filter and drink 100 ml twice a day;
yarrow infusion - add a glass of boiling water to 10 g of raw materials, insist 2 hours; the cooled drink is drunk in small portions per day;
oatmeal broth - a liter of boiling water is added to a glass of oats and boiled for 30 minutes, the finished mixture is filtered; drink a mucous decoction of 100 ml up to 4 times a day;
bearberry infusion - 20 g of raw materials are poured into 250 ml of boiling water, insisted in a thermos for 4 hours; take 50 ml three times a day before meals.

Forecast and prevention

The leading goal of preventing pyelonephritis in men is to eliminate factors that increase the risk of infection of the renal system. TO preventive measures include:

early diagnosis and treatment of chronic diseases of the urogenital area;
personal hygiene;
maintaining an active lifestyle with the rejection of alcohol and nicotine;
refusal of one-time sexual relations;
hardening procedures.

When anxiety symptoms on the part of the renal system (pain in the lower back and lower abdomen, problems with emptying the bladder, clouding of the urine) you can not self-medicate - only a urologist can confirm the diagnosis of "pyelonephritis". Self-administration of antibiotics and other drugs aggravates the course of the disease and leads to disastrous consequences.

Pyelonephritis is a disease that is characterized by an inflammatory process in the kidneys. It has always been considered a "female disease", but sometimes pyelonephritis is diagnosed in men. Symptoms and treatment depend on the form of the disease, as well as comorbidities. Therefore, in order to prevent complications, you need to know what the signs of this disease are for timely seeking medical help.

Classification

Pyelonephritis is of two types:

Also, the disease is divided into forms:

Primary is diagnosed in boys who have not reached the age of 7, as well as in immunocompromised men. This type of pyelonephritis can only be acute.

The secondary concerns the elderly representatives of the stronger sex. It can be both acute and chronic.

Pyelonephritis that affects only one kidney is called unilateral. In the case when the inflammatory process develops in both kidneys at the same time, the disease is called bilateral pyelonephritis.

Primary pyelonephritis provokes hypothermia (this often happens to children in the cold season). Also, the cause may be vitamin deficiency, which weakens immune system, and that, in turn, cannot fully “protect” the internal organs.

Other provoking factors are:

emotional instability, frequent stressful situations, excitement;
excessive physical activity;
alcohol abuse;
smoking;
active breeding pathogenic bacteria due to reduced protective reactions of the body;
diabetes.

Why does secondary pyelonephritis occur? Symptoms in men, talking about problems with the kidneys, do not appear immediately. After all, the infection initially affects the bladder (urine stagnates due to impaired functioning of the urinary system), and then passes to the kidneys. And not always men pay attention to suspicious symptoms from the urinary tract. This is how secondary pyelonephritis occurs.

Its main reasons:

prostatitis;
prostate adenoma (urine outflow is disturbed due to the pressure of the prostate on the urinary canal);
urolithiasis (small calculi sometimes block the path for the normal outflow of urine, and this entails congestion).

Signs of acute pyelonephritis

Symptoms of acute pyelonephritis in men develop very quickly. Such signs are characteristic of most ailments accompanied by an inflammatory process in the body:

a significant increase in body temperature;
weakness;
chills;
aches;
general malaise;
thirst;
frequent urge to urinate.

After some time, a pulling pain in the lumbar region is added to these symptoms. A man must pay attention to the state of urine:

it becomes cloudy;
there is an unpleasant pungent smell, which was not observed before.

Whether it is possible most at once to understand, what is it a pyelonephritis? Symptoms in men, as in women, of this disease are very similar to other kidney diseases. Therefore, it is important to immediately contact a doctor who will help in this situation.

Symptoms of chronic pyelonephritis

Often people self-medicate. They use the advice of relatives, information from other sources, but categorically refuse to visit a doctor. As a result, the acute form becomes chronic. How does chronic pyelonephritis manifest itself in men?

worried about pain in the lower back of a aching character;
the urge to go to the toilet occurs more often than usual, especially at night;
body temperature unreasonably rises in the evenings;
worried about frequent headaches;
swelling that occurs in the morning;
when walking, the lower back begins to hurt;
the patient is always cold in the lumbar region.

The chronic form is sometimes characterized by symptoms of acute pyelonephritis.

Survey

How diagnostic methods require pyelonephritis? Symptoms in men, which he must tell the urologist in detail, become the reason for the examination. To make an accurate diagnosis, as well as determine the location of inflammation, it is necessary to combine laboratory methods with instrumental. In the case of pyelonephritis in men, attention will need to be paid to diseases of the prostate gland.

general blood analysis;
examination of urine (general and daily analysis, according to Nechiporenko, and other methods that the doctor considers necessary).

Ultrasound of the bladder and kidneys, abdominal organs;
cystoscopy;
urography;
CT and MRI (if necessary).

How to help the patient?

Self-medication is strictly prohibited. This leads to dangerous consequences.

Treatment depends on the severity of the disease. The main task:

reduce pain;
restore normal urine flow;
relieve inflammation;
eliminate the root cause.

How is pyelonephritis treated in men? Symptoms and treatment depend on the form of the disease - acute, chronic.

Acute treatment

The acute form of the disease requires urgent hospitalization of the patient. He must observe bed rest in the first days of being in the hospital. The patient is prescribed a salt-free diet, as well as compliance with the drinking regime - drink 1 to 2.5 liters of fluid per day.

To improve blood circulation, a warm compress is applied to the lower back. It is recommended to use diathermy of the lumbar region.

Treatment of pyelonephritis in men with antibiotics requires a preliminary study of the sensitivity of the microorganism to a particular active substance. The course of antibiotic therapy is at least 4 weeks. If the symptoms of the disease no longer bother, then you can not stop taking the drug.

Treatment of the chronic form

To cure this form of pyelonephritis, you need to be patient, because this will take a lot of time. In such cases, the patient is prescribed antibiotics, which are constantly changing (with mandatory monitoring of the sensitivity of microorganisms to a new drug). The chronic form of the disease requires an integrated approach to treatment. Not only drug therapy is used, but also traditional medicine. The patient must be on a diet.

ethnoscience

Treatment of pyelonephritis in men with folk remedies should be under the supervision of a doctor. After all, sometimes, independently picking up a seemingly harmless remedy for yourself, you can cause irreparable harm.

Take dried hop cones (2-3 tablespoons) and pour 0.5 liters of boiling water. The remedy should be infused for about two hours, after which it must be filtered. Application: drink 0.5 cup every 2 hours. Hops help the kidneys cleanse in a few days.
Daily use a few tablespoons of nasturtium officinalis (sold in pharmacies). If you can find fresh, you can add it to salads. The course of treatment is a month.
Cranberry tincture. For cooking, you need to mix 1 tablespoon of chopped berries with a glass of boiling water. Let it brew for 2 hours, and then strain. Drink half a glass 3 times a day. The course of treatment is 2 weeks.
Tincture of lingonberry leaves and honey. To prepare a remedy you will need:

3 spoons of lingonberry leaves;
2 spoons of honey;
0.5 l of water.

Mix honey with leaves and pour boiling water. Let it brew for 3 hours, and then strain. Take 2 tablespoons of tincture 3 times a day, preheated.

Complications

What are the consequences of pyelonephritis? Symptoms in men are not always taken into account. Also, representatives of the stronger sex sometimes interrupt the course of treatment in the middle of the journey. If this happens, then pyelonephritis can give serious complications:

the transition of the acute form of the disease to the chronic;
pyonephrosis;
pedunculitis;
necrotic papillitis (often diagnosed and diabetics);
kidney failure.

Preventive measures

A healthy lifestyle and following certain rules will help prevent the development of pyelonephritis:

Drink enough liquid daily. This will flush out the accumulated bacteria from the bladder.
Refuse alcoholic beverages.
Eat foods rich in vitamin C, which is also found in cranberry juice and all juices. An acidic environment prevents microbes from multiplying.
Timely treat diseases of the prostate, bladder.
Do not delay going to the toilet for a long time.
Observe personal hygiene.

Now it is known what is pyelonephritis in men, symptoms and treatment, drugs that are used in the treatment of this disease. But the most important thing is to know how to prevent the development of the disease, because it threatens the development of dangerous consequences.

Pyelonephritis is a dangerous pathology of the kidneys. An acute inflammatory process is activated against the background of the penetration of pathogenic microorganisms in an ascending or descending way. Untimely therapy causes complications, the patient's condition deteriorates sharply.

Why does pyelonephritis develop in men? Symptoms, treatment and prevention of the disease are described in the article.

Causes of pyelonephritis in men

Inflammation of the kidneys in men develops under the influence of many factors:

prostatitis;
urolithiasis disease;
prostate adenoma;
surgical treatment, urological manipulations in the organs of the genitourinary system;
hypothermia;
weakened immunity;
long stay at the workplace in a sitting position;
natural aging processes (pyelonephritis often develops in older patients).

Pyelonephritis ICD code - 10 - N10 - N12.

Classification

Types of pathology:

acute pyelonephritis;
chronic pyelonephritis.

Learn how to do uroflowmetry and see a breakdown of the results.

About the rules of nutrition and diet for urolithiasis in women is written on this page.

Ways of infection:

ascending- from the external genitalia, a bacterial infection rises to the kidneys;
hematogenous (through the blood). An active or chronic inflammatory process in the body makes the kidneys vulnerable, infectious agents easily penetrate the natural filter with the flow of lymph and blood.

Signs and symptoms

The main signs of pyelonephritis of the kidneys:

aching pain in the lumbar region on one or both sides. A characteristic feature is that noticeable discomfort does not disappear when the position of the body changes;
violation of the color of urine, turbidity of urine, the appearance of foam, mucus in the excreted fluid, blood clots. Often, urine acquires a dark, almost brick shade;
signs of intoxication: general weakness, drowsiness, aching joints, chills;
subfertile temperature rises to 37, often 38 degrees. At acute form, the active spread of infection, the temperature rises to 40 degrees, immediate hospitalization is required;
urine discharge becomes more frequent, cramps appear during urination, pain syndrome develops. With an increase in intoxication, negative signs intensify;
against the background of an increase in the volume of circulating blood, problems with the excretion of fluid, pressure rises (secondary hypertension);
after a few days, in the absence of adequate therapy, the symptoms become more pronounced, the patient's condition worsens, pus appears in the kidneys, nephrons sometimes die, and the functions of important organs are disrupted.

Diagnostics

To confirm pyelonephritis in men, prescribe:

blood chemistry;
general urine analysis to detect pathogenic microflora;
complete blood count to control the level of ESR and leukocytes;
computed or magnetic resonance imaging, ultrasound of the kidneys.

Effective Treatments

What and how to treat pyelonephritis? With severe symptoms, the development of purulent complications, a rapid deterioration in the condition, therapy is carried out in a hospital. In some cases, urgent surgery is required. When vomiting occurs, high pressure, dysuria bed rest is important. With a moderate nature of negative manifestations, the patient is treated at home, visits a urologist at a certain time.

Conservative therapy

Effective names and types of drugs for the treatment of pyelonephritis:

antibiotics for pyelonephritis in men. Fluoroquinolones, a combination of clavulonic acid + Amoxiclav, third and fourth generation cephalosporins;
with prostatitis, antibiotics and NSAIDs are prescribed;
intravenous infusions with the use of fizrastovr;
with sufficient patency of the urinary tract, diuretics, antispasmodics are prescribed;
antipyretic at high temperature;
with chronic pyelonephritis positive result give natural uroseptics (cranberries, lingonberries, Monurel tablets);
fortifying compounds, vitamins;
analgesics are recommended to reduce pain.

Folk remedies and recipes

A good addition to taking antibiotics is herbal decoctions. Vegetable raw materials correct application reduces inflammation, activates the outflow of urine, improves kidney function. The list of compositions is important to agree with the urologist.

It is forbidden to take herbal decoctions, healing teas as the main means of combating bacterial infection: anti-inflammatory, antiseptic properties of natural compounds are several times lower than those of powerful synthetic drugs. In the chronic course of the disease, products based on fruits and herbs have a positive effect on the functionality of natural filters, and prevent the reproduction of pathogenic microorganisms.

Effective folk remedies for pyelonephritis:

decoction of hop cones;
Mint tea;
decoction of rose hips;
infusion of corn stigmas;
lingonberry leaf tea;
chamomile decoction;
infusion of bearberry or knotweed.

Possible Complications

The lack of timely treatment, the use of herbal decoctions instead of antibacterial agents, violation of the doctor's recommendations are factors that provoke serious problems with the functioning of natural filters. Inattention to acute symptoms, taking inappropriate medications reduces the clinical manifestations of the disease, but pathogenic microorganisms remain in the kidneys and urinary tract, the pathology passes into the chronic stage.

A dangerous phenomenon is the spread of infection through tissues and organs. Systemic blood poisoning (sepsis) in advanced cases leads to acute intoxication, the probability of death is high.

Other complications of pyelonephritis:

chronic renal failure;
purulent inflammation, difficult to treat;
persistent increase in blood pressure.

On a note:

taking antibacterial formulations at the initiative of the patient, before the test for sensitivity to antibiotics, interferes with treatment, “lubricates” the picture of the pathology;
many formulations are not prescribed for kidney diseases: you need to choose medicines that act throughout the urinary tract without changing the shape and state of the active substance;
for this reason, pyelonephritis is prescribed antibacterial drugs strictly defined groups. Even the generation of drugs significantly affects the effectiveness of treatment, prevents bacterial resistance to antibiotics.

Learn about the causes of kidney inflammation and the treatment of pathology with medications.

About the causes and treatment of pain in the lower abdomen when urinating in women is written on this page.

Go to http://vseopochkah.com/mochevoj/zabolevaniya/vospalenije-u-zhenshin.html and see the list and characteristics of pills for inflammation of the bladder in women.

After eliminating the inflammatory process in the kidneys, it is important to follow the rules to prevent relapses. Nephrologists do not recommend violating the recommendations: exacerbations are a common problem after treatment. It is difficult to deal with the chronic form of pyelonephritis. It is important to pay more attention healthy lifestyle life.

Basic rules for the prevention of pyelonephritis:

quitting smoking, excess alcohol;
hypothermia warning;
proper nutrition to reduce the risk of urolithiasis;
control of chronic pathologies that develop with impaired metabolism;
timely treatment of prostatitis;
physical activity;
refusal of spices, spicy dishes, smoked meats;
strengthening immunity;
clean drinking water in the amount of two liters per day to flush out salts, toxins, decay products from the kidneys;
treatment of diseases of the genitourinary system, protection against sexually transmitted infections;
elimination of foci of inflammation in the body.

Learn more about the symptoms and features of the treatment of pyelonephritis in men from the following video:

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