Classical treatment of abscess of any localization includes percutaneous or open drainage. In case of its early beginning in the stage of infiltration the conservative treatment comprises intravenous antibiotic therapy and careful observation, thus you can avoid surgery of abscesses with a diameter less than 3 cm (1, 2). (2, 7, 8): after the conservative antibiotic therapy in 17 patients with kidney abscess (diameter <4 cm) 90% of patients were cured. Abscesses with diameter of 3–5 cm or less in the patients with immunodeficiency and in patients whose condition does not improve under the influence of antibiotics should be drained percutaneously (4, 5, 6).

(3, 9): percutaneous drainage in 25 patients was successful in 80% of cases. So far unresolved is the question of the indications for minimally invasive drainage of purulent processes of the upper urinary tract and pelvis and timing of open surgery in case of inefficiency of the minimally invasive methods.

The purpose of the work was to examine the evidence and effectiveness of minimally invasive treatment of kidney abscess and purulent paranephritis. Based on the purpose the objectives of the research were as follows:

1) To investigate the effectiveness of treatment of patients with kidney abscess with percutaneous puncture under ultrasound control

2) Set the effectiveness of percutaneous puncture purulent paranephritis controlled ultrasonography

We analyzed the results of treatment of 29 patients with purulent processes of kidneys and paranephric space treated in 2004–2006 by the minimally invasive methods (percutaneous drainage) under the ultrasonic control: kidney abscess – 23 patients, purulent paranephritis – 6 patients.

There were 17 men and 12 women among the treated patients. Age of male and female patients was 47±0.4 and 42±0.4 subsequently. Percutaneous drainage was applied for the treatment of kidney abscess in 23 patients and purulent paranephritis in 6 patients. Size of the kidneys abscess was ≤ 5 cm in 12 patients, up to 7 cm in 8 patients and > 7 cm in 3 patients. Size of the purulent paranephritis was ≤ 4 cm in 4 patients, up to 10cm in one patient and > 10 cm also in one patient.

According to the etiology (Table 2) purulent processes of kidneys and paranephric space were often caused by the urinary stone disease complicated by the kidney blockage. The results of treatment of these patients were satisfactory. No complications were observed during the operation and in the early postoperative period. Conclusions:

• Minimally invasive treatment of purulent processes of kidney and paranephric space is highly effective and safe

• Most kidney abscesses develop as a complication of urolithiasis on a background urine stasis (15 of 25 patients) at least for no apparent reason (5 patients), and against the background of diabetes (3 patients)

• Most abscesses are localized in the left kidney (in 14 of 23 patients), paranephritis equally observed on both sides

• The majority of patients in 12 of the 23 dimensions abscesses kidney did not exceed 5 cm to 7 cm was found in 8 patients, most patients had 4 of 6 paranephritis up to 4 cm

Keywords: kidney abscess, purulent processes of paranephric space, ultrasonography, minimally invasive surgery, percutaneous drainage of purulent processes of upper urinary tract

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