Minimally invasive treatment of emphysematous pyelonephritis in diabetic patients: a comparative study

Emphysematous pyelonephritis (EPN) is a rare but high-mortality infectious disease most commonly seen in diabetic patients, and the timing of percutaneous catheter drainage (PCD) is crucial for its prognosis. A retrospective analysis was conducted on data of 18 patients diagnosed with diabetes mellitus complicated EPN who were treated in the Urology of the General Hospital of Northern Theater Command between November 2019 and March 2024. The patient cohort was stratified into two groups according to the timing of PCD implementation: the Early PCD group (E-PCD group, n = 11) (≤ 24 h) and the Delayed Salvage PCD group (DS-PCD group, n = 7) (converted to PCD after failure of conservative pharmacotherapy). By comparing of the comprehensive indicators, the clinical value of early PCD was clarified. The general status recovery time, average hospitalization time, average recovery time, and the recovery time of related infection indicators at multiple sampling time points after treatment in the E-PCD group were significantly shorter than those in the DS-PCD group. The volume change rate of pus cavity of E-PCD was significantly higher than that of DS-PCD group at different unit time periods respectively. Compared with delayed salvage PCD, early ultrasound-guided PCD within 24 h in diabetic patients with EPN can effectively drain pus, quickly control infection symptoms, and accelerate patient recovery.