8% of women in america will develop kidney stones within their lifetime. treatment in those extreme situations, in which kidney stones are too large to pass on their own, patients may seek removal. most of these treatments involving kidney stone removal are done by a urologist; a physician who specializes in the organs of the urinary system. a common way of removal is shock wave lithotripsy, in which the urologist will shock the kidney stone into smaller pieces via laser, allowing these pieces to further pass through the urine on their own, as a normal case of kidney stones. larger, more serious cases may demand cystoscopy, ureteroscopy, or percutaneous nephrolithotomy, in which the doctor will use a viewing tool or camera to locate the stone, and based on the size or situation, may either chose to continue with surgical removal, or use the shock wave lithotripsy treatment. once the kidney stone(s) are successfully eliminated, the urologist will commonly suggest medication to prevent future recurrences. pyelonephritis main article: pyelonephritis pyelonephritis is a type of urinary tract infection that occurs when bacteria enters the body through the urinary tract. it causes an inflammation of the renal parenchyma, calyces, and pelvis. there are three main classifications of pyelonephritis: acute, chronic and xanthogranulomatous. acute pyelonephritis in acute pyelonephritis, the patient experiences high fever, abdominal pain and pain while passing urine. treatment for acute pyelonephritis is provided via antibiotics and an extensive urological investigation is conducted to find any abnormalities and prevent recurrence. chronic pyelonephritis in chronic pyelonephritis, patients experience persistent abdominal and flank pain, high fever, decreased appetite, weight loss, urinary tract symptoms and blood in the urine. chronic pyelonephritis can also lead to scarring of the renal parenchyma caused by recurrent kidney infections. xanthogranulomatous pyelonephritis xanthogranulomatous pyelonephritis is an unusual form of chronic pyelonephritis. it results in severe destruction of the kidney and causes granulomatous abscess formation. patients infected with xanthogranulomatous pyelonephritis experience recurrent fevers, anemia, kidney stones and loss of function in the affected kidney. treatment a urine culture and antibiotics sensitivity test is issued for patients who are believed to have pyelonephritis. since most cases of pyelonephritis are caused from bacterial infections, antibiotics are a common treatment option. depending on the species of the infecting organism and the antibiotics sensitivity profile of the organism, treatments may include fluoroquinolones, cephalosporins, aminoglycosides, or trimethoprim individually or in combination. for patients with xanthogranulomatous pyelonephritis, treatment might include antibiotics as well as surgery. nephrectomy is the most common surgical treatment for a majority of cases involving xanthogranulomatous pyelonephritis. epidemiology in men, roughly 2-3 cases per 10,000 are treated as outpatients and 1 in 10,000 cases require admission to the hospital. in women, approximately 12–13 in 10,000 cases are treated as outpatients and 3-4 cases are admitted to a hospital. the most common age group affected by xanthogranulomatous pyelonephritis is middle-aged women. infants and elderly are also at an increased risk because of hormonal and anatomical changes.