Erim ERSOY, Cem Nedim YÜCETÜRK, Berat Cem ÖZGÜR, Buğra Bilge KESEROĞLU, Ali AYYILDIZ, Veli Mert YAZAR

GEBELERDE RENAL KOLİKLİ HASTAYA YAKLAŞIM; ANKARA EĞİTİM VE ARAŞTIRMA HASTANESİ DENEYİMİ

AMAÇ: Gebelerde obstetrik olmayan nedenlerle hastaneye yatışınen sık sebebi renal koliktir. Hastanemize başvuran, gebelerin 121tanesi renal kolik tanısı almıştır. Bu hastalar uygulanan medikal vecerrahi tedavilerin karşılaştırılması amaçlanmıştır.GEREÇ VE YÖNTEMLER: Gebe olup hastanemizin acil, kadındoğum ve üroloji polikliniklerine başvuran, renal kolik tanısı alanhastalar retrospektif olarak değerlendirildi. Bu hastaların; yaşı, gebeliğin hangi üç aylık döneminde olduğu, semptomları, idrar analizive ultrasonografi sonuçları ve yaklaşım protokolleri değerlendirildi.Konservatif tedavi ve cerrahi müdahale yapılan hastalar karşılaştırıldı.BULGULAR: Hastaların 41(%33.9) tanesi birinci trimester de,20(%16.5) tanesi ikinci trimesterde geri kalan 60(%49.6) tanesiüçüncü trimesterde idi. Hastaların yaş ortalaması 26.2 bulundu.Hastaların 70(%57.8)’ine konservatif tedavi, 50(%41.3)’sine üreteralstent yerleştirilmesi 1(%0.9)’ine perkütan nefrostomi takıldı. Uygulan tedaviler gebelik dönemlerine göre değişiklik gösterdi.SONUÇ: Biz, bu çalışmada toplam 121 hastayı değerlendirdik. Hastaların çoğunluğu70 (%57.8) konservatif tedaviden fayda gördüler.Konservatif tedaviden faydalanamayan ve fayda göremeyeceği dü- şünülen 50 hastada (%41.3) ureteral stent yerleştirildi. Piyonefrozsaptanan bir hastaya perkütan nefrostomi yerleştirildi. Hastalarınkonservatif tedaviden bu oranda (%57.8) fayda görülmesi literatürleuyumludur. Bu çalışmanın sonuçları değerlendirildiğinde üçüncütrimesterde konservatif tedavinin etkinliğinin gebeliğin ilk dönem- lerine göre azaldığı görülmüştür.

EVALUATION OF RENAL COLIC IN PREGNANCY; EXPERIENCE OF ANKARA TRAINING AND RESEARCH HOSPITAL

INTRODUCTION: In pregnancies, the most common reason for hospitalization for non-obstetric causes is renal colic. 121 of the pregnant patients who applied to our hospital had renal colic and it was aimed to compare the medical and surgical treatments applied to these patients in order to give insight to treatment strategies. MATERIAL AND METHODS: We retrospectively evaluated pregnant patients with renal colic those referred to emergency, obstetrics and urology clinics of our hospital.The age, the period of the gestation, symptoms, urinalysis and ultrasound results, and attentional protocols were retrospectively evaluated. Conservative treatment and surgical intervention were also compared. RESULTS: Of 121 patients, 41 (33.9%) were in the first trimester and 20 (16.5%) were in the second trimester and 60 (49.6%) were in the third trimester. The average age of the patients was 26.2 years. Conservative treatment was applied to 70 (57.8%) patients, ureteral stent placement was performed in 50 (41.3%), while percutaneous nephrostomy was performed in 1 (0.9%) The treatments applied varied according to gestational age. CONCLUSION: The majority of patients (57.8%) benefited from conservative treatment. In fifty patients (41.3%) ureteral stents were placed. In only one patient percutaneous nephrostomy was placed with pyelonephrosis. The success of the conservative treatment of the patients (57.8%) is compatible with the literature. It was seen that the effectiveness of conservative treatment decreased in the third trimester compared to the first and second trimester of pregnancy.

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