Ureteral stent placement in hydronephrosis during pregnancy

Abstract

In this study we describe 22 cases of retrograde ureteral stent placement in pregnant women with therapy-resistant flank pain due to hydronephrosis. Eleven were primiparous and one patient expected twins. Eight of 22 patients presented symptoms of pyelonephritis. In 21 cases the hydronephrosis was located on the right and in 4 cases it was bilateral. Maximal lower calix diameter was 12 mm (range 9-22 mm). With the exception of two cases, sonographically controlled stent placement was performed under local anesthesia without sedation. All patients were painfree within 6 days and were given prophylactic low doses of antibiotic until the day of delivery. Renal function remained within the normal limits. Double-J stent displacement occurred in 3 patients - of which one underwent nephrostomy. Postnatal examination demonstrated urolithiasis in 4 of 19 patients. This study provides evidence for effectiveness of retrograde ureteral Double-J stent placement as a therapeutic option in cases of severe symptomatic hydronephrosis during pregnancy with a low morbidity rate.

Double-J ureteric stenting in pregnancy: A single-centre experience from Iraq

“…It was reported that JJ ureteric stenting can be difficult in the third trimester due to the tortuosity of the ureter [13] . However, others did not confirm this [9–12,14–16] . All patients in our series had successful stenting.…”

Comparison of percutaneous nephrostomy and double J stent in symptomatic pregnancy hydronephrosis treatment

“…They concluded that internal drainage should be well evaluated in complicated pregnancy hydronephrosis (20). Several studies have shown that DJS is an effective and safe method for symptomatic pregnancy hydronephrosis treatment (6,7,21,22). However, most of these studies are small case-group and noncomparative studies.…”

“…If there is no amelioration of symptoms despite a conservative approach, interventional treatments such as ureteral catheterization and percutaneous nephrostomy (PCN) may be required. Both PCN and double J stenting (DJS) are widely used methods to alleviate hydronephrosis in pregnancy (6,7). Symptomatic hydronephrosis is a urological emergency as it may cause premature labor and should be alleviated as quickly as possible.…”

Intracardiac migration of ureteral double-J stent: A case report and review

“…4 When symptoms of urolithiasis in a pregnant patient are refractory to conservative treatments, such as analgesics, or if the patient becomes complicated by infection or acute renal failure or when symptomatic or severe hydronephrosis occur, temporizing measures such as ureteral stent or PCN are frequently used. 5,6 Intracardiac migration of ureteral double-J stent: A case report and review case repOrt led to an increase in potential complications from minor clinical symptoms, such as frequency, dysuria or mild intermittent hematuria to more severe problems, such as stent slipping, upward migration, fragmentation, encrustation, stone formation, subsequent ureteral obstruction, infection, unresolved hydronephrosis and ureteral fistula. 3 Migration into the renal pelvis ranges from 0.6 to 8.2%).…”