About pathogenetic therapy of chronic pyelonephritis after cystectomy

Treatment of chronic pyelonephritis after cystectomy is a complex and unresolved problem. Its difficulty lies in the fact that, firstly, regardless of the methods of urine removal, all patients after cystectomy develop urodynamic disorders of the upper urinary tract, which, being the main pathogenetic factor of secondary chronic pyelonephritis, contribute to its occurrence and further progression. Secondly, the majority of patients undergoing bladder removal surgery for malignant neoplasms have secondary chronic pyelonephritis. Thirdly, etiotropic treatment of chronic pyelonephritis without restoring the impaired urodynamics of the urinary tract is ineffective and does not prevent the progression of the pathological process. This explains the high mortality from chronic renal failure in patients who successfully underwent cystectomy.