FOCAL XANTHOGRANULOMATOUS PYELONEPHRITIS - PARTIAL NEPHRECTOMY AS DEFINITIVE TREATMENT

Objectives: We report 11 cases of focal xanthogranulomatous pyelonephr itis (FXGP), a disease that is very uncommon. The aim of the present w ork is to assess the effectivity of conservative treatment. Material a nd Methods: Eleven of the 82 cases of XGP (12.5%) diagnosed between 19 70 and 1995 presented the focal form (FXGF). Clinical features, labora tory findings, radiological imaging studies, surgical treatment and fo llow-up were evaluated. Results: FXGP occurred in middle-aged women (f emale/male ratio 4.5:1) who had a history of calculosis, urinary infec tions produced by Escherichia coli and Proteus mirabilis, or urinary t ract abnormalities. FXGP was unilateral in all cases. The most frequen t symptom was flank pain. Some hematological and biochemical parameter s were altered. Intravenous urography and sonography revealed calculos is, hydronephrosis or renal mass, but these findings are nonspecific. Only abdominal CT scan can establish the correct diagnosis. Five of th ese patients (45.5%) underwent partial nephrectomy at our hospital. Du ring the follow-up, patients showed no relapse in the ipsilateral or c ontralateral kidney. Serum parameters were in normal range. Conclusion : When FXGP is diagnosed, local excision is recommended in all cases, since relapse in the affected kidney is unusual.