Korean J Urol.  2006 Nov;47(11):1220-1224. 10.4111/kju.2006.47.11.1220.

The Usefulness of Ureteral Stenting for Acute Ureteral Obstruction in Pregnancy

• Kim SD
• Sung LH
• Noh CH

• KMID: 2294282
• DOI: http://doi.org/10.4111/kju.2006.47.11.1220

Abstract

Purpose
An acute ureteral obstruction during pregnancy presents both diagnostic and therapeutic challenges. When conservative therapy fails, temporary measures, such as ureteral stenting, are often chosen as a first- line intervention, which postpones definitive management until delivery. The usefulness of ureteral stenting was evaluated as an emerging strategy for the symptoms of an acute ureteral obstruction during pregnancy.
Materials and Methods
Between 1996 and 2005, a retrospective analysis was performed on 53 pregnant patients with an acute ureteral obstruction. Eighteen of the patients were treated by ureteral stenting, as they failed to improve with conservative management. They were followed up until the removal of the ureteral stent.
Results
Seventeen patients (95%) experienced significant pain relief within at least 2 days, but one patient (5%) did not. On ultrasound, 16 patients (88%) had resolution of hydronephrosis. Twelve patients (66%) continued to have problems with post-therapeutically irritative voiding symptoms, but 11 (61%) experienced relief of symptoms within 10 days. One patient (5%) had the ureteral stent removed due to the continuous complaint of irritative voiding symptoms. After delivery, all patients were taken intravenous pyelography (IVP). Fourteen patients showed normal findings, but 4 were diagnosed with a ureteral stone. Three patients were treated by extracorporeal shock wave lithotripsy (ESWL) for a stone in the upper and lower urinary tract. One patient, with a mid ureteral stone, was treated by ureteroscopic lithotripsy.
Conclusions
Ureteral stents were usually placed without any major problems, and well tolerated, with only minor and short post-therapeutic discomfort. We concluded that ureteral stenting is a simple, safe and effective first-line therapeutic option in case of symptomatic and acute ureteral obstruction during pregnancy.

Keyword

Pregnancy; Ureteral obstruction; Stents

MeSH Terms

Humans
Hydronephrosis
Lithotripsy
Pregnancy*
Retrospective Studies
Shock
Stents*
Ultrasonography
Ureter*
Ureteral Obstruction*
Urinary Tract
Urography

Figure

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  Fig. 1 Ultrasonic follow-up on ureteral stenting during pregnancy (n=18).

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