[Urodynamics of the upper urinary tract in urolithiasis patients with chronic pyelonephritis].

Urodynamics was studied in patients with chronic pyelonephritis with a various level of upper urinary tract (UUT) obstruction. 90% patients with concrements of the low ureter had high intrapelvic pressure (IPP)--21.8 +/- 0.8/25.2 +/- 0.8 cm of water column (basal/peristaltic) and enhanced UUT contractility. IPP was elevated in 50% patients with proximal UUT obstruction (11.8 +/- 1.3/15.5 +/- 1.5 cm of water column) and it rose noticeably (by 110-184%) in changing body position (orthostatic test) but changed little in the respiratory test. High IPP persisted despite functioning nephrostomic drainages in 84-86% patients exposed to extracorporeal and/or contact lithotripsy at the average level 16.2 +/- 0.8/19.7 +/- 0.6 cm of water column. Different mechanisms may be involved in formation of high IPP in patients with chronic pyelonephritis and varying level of UUT obstruction. In view of damaging influence of high IPP on renal function the physician should control this index during the treatment and take additional measures to prevent elevation of IPP.