The article presents an analysis of the treatment results of 1122 patients with pyelonephritis in pregnancy at different gestational periods (from 6 to 39-40 weeks of pregnancy). The age of the patients was from 16 to 41 years, the average age was 26.15 ± 7 years. The indications and methods of urinary tract drainage in pregnant women were analyzed depending on the causes of urodynamic disturbances (kidney stone disease, decreased urinary tract tone, ureters compression by the uterus, vesico-urethral reflux) pregnancy term; pyelonephritis in pregnancy stage (serous/ purulent). Errors in the patients’ management after purulent pyelonephritis in pregnancy are considered. The expediency of examining and treating patients with risk factors for urinary tract infections during pregnancy were indicated at the stage of preparing a woman for pregnancy. Antegrade draining of the urinary tract is indicated for pregnant women from the 31st pregnancy week (and even shorter periods with a pronounced violation of urodynamics) with the presence of knee-shaped deviation in the ureter`s upper third and with suspected purulent process. Therefore, nephrostomy draining provides a more adequate outflow of urine from the affected kidney and makes it possible to control daily diuresis. It is necessary to conduct active monitoring of pregnant women with the presence of internal ureteral stents and their timely replacement. It is advisable to remove the drainage 3-4 weeks after birth, depending on the causes of the urodynamics` disorders. Symptom build-up dynamics, severity of intoxication, multi-organ lesion, the possibility of antenatal death of the fetus require urgent choice of the method of urinary tract drainage and the early initiation of intensive therapy in patients with suspected purulent process. Antimicrobial therapy should be carried out in accordance with the Russian guidelines on Urinary tract infections.TThe study did not have sponsorship. The authors have declared no conflicts of interest.

Introduction. Purulent pyelonephritis is a complicated urinary tract infection with one of the most severe currents. It represents a serious clinical problem associated with the complexity of the choice of diagnosis and the optimal active treatment strategy, as well as the need for subsequent rehabilitation of this category of patients.Purpose of the study. Studying of the immediate and remote results of the kidneys` functional state in patients who have undergone purulent pyelonephritis using a differentiated approach to treatment tactics.Materials and methods. The study included 84 patients who underwent purulent pyelonephritis at the age of 15 to 70 years old and were treated at the Botkin City Clinical Hospital from 1999 to 2007. The patients were divided into three groups depending on the method of treatment: group 1 - open surgery of 18 patients (21.4%); group 2 - percutaneous drainage methods - 38 (45.3%); group 3 - conservative therapy - 28 (33.3%) patients. Examination of patients included dynamic nephroscintigraphy and complex ultrasound. It was performed in time after treatment after 12, 36 and 60, 84 months.Results. During the 7-year observation of patients, it was found that a more pronounced renal dysfunction and perfusion occurred during all periods of observation after undergoing open surgery according to Doppler sonography. Restoration of renal function occurred in shorter observation periods after the use of percutaneous kidney drainage and conservative treatment.Conclusion. Based on the data obtained, it can be concluded that a differentiated approach to the choice of tactics for the treatment of patients with purulent pyelonephritis is reasonable. Accordingly, it should be introduced into clinical practice of urological departments that provide emergency care to urological patients.