Comparison of percutaneous nephrostomy and double J stent in symptomatic pregnancy hydronephrosis treatment
Comparison of percutaneous nephrostomy and double J stent in symptomatic pregnancy hydronephrosis treatment
Background/aim: We aimed to compare the success rate of percutaneous nephrostomy (PCN) and double J stenting (DJS) in thetreatment of symptomatic pregnancy hydronephrosis.Materials and methods: Diagnosis and grading of hydronephrosis were performed by urinary ultrasound (USG) and Doppler modewas used for evaluation of renal arterial resistivity index (RI). Patients were divided into two groups according to the method used forthe treatment of hydronephrosis: group A (PCN, n = 38) and group B (DJS, n = 46). A P value < 0.05 was considered significant.Results: The number of patients requiring second intervention was higher in group B (P = 0.0018) and time to secondary interventionwas significantly earlier in group B also (P = 0.0025). The number of tertiary intervention was again higher in group B (5/16 vs. 1/6)and the need for tertiary intervention was higher in patients who underwent DJS implantation as a secondary intervention than thosewho underwent PCN (5/11 vs. 1/11, P = 0.0012). The time to tertiary intervention was longer in patients with PCN than in those withDJS (P = 0.0048).Conclusion: PCN may be preferred to DJS in symptomatic pregnancy hydronephrosis because it requires fewer re-interventions afterlonger times.
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- Swanson SK, Heilman RL, Eversman WG. Urinary tract stones
in pregnancy. Surg Clin North Am 1995; 75: 123-142.
- Biyani C, Joyce A. Urolithiasis in pregnancy. II: management.
BJU Int 2002; 89: 819-823.
- Di Salvo DN. Sonographic imaging of maternal complications
of pregnancy. J Ultrasound Med 2003; 22: 69-89.
- Irving SO, Burgess NA. Managing severe loin pain in pregnancy. BJOG 2002; 109: 1025-1029.
- Kavoussi. Percutaneous management of urolithiasis during
pregnancy - management of urinary calculi during pregnancy
- stones in pregnancy and children - reply. J Urol 1993; 150:
199-199.
- Sadan O, Berar M, Sagiv R, Dreval D, Gewurtz G, Korczak D,
Zakut H, Bernstein D. Ureteric stent in severe hydronephrosis
of pregnancy. Eur J Obstet Gynecol Reprod Biol 1994; 56: 79-
81.
- John H, Vondruska K, Sulser T, Lauper U, Huch A, Hauri D.
Ureteral stent placement in hydronephrosis during pregnancy.
Urologe A 1999; 38: 486-489.
- Goldfarb RA, Neerhut GJ, Lederer E. Management of acute
hydronephrosis of pregnancy by ureteral stenting: risk of stone
formation. J Urol 1989; 141: 921-922.
- Waltzer WC. The urinary tract in pregnancy. J Urol 1981; 125:
271-276.
- Fainaru O, Almog B, Gamzu R, Lessing JB, Kupferminc M. The
management of symptomatic hydronephrosis in pregnancy.
BJOG 2002; 109: 1385-1387.
- Choi CI, Yu YD, Park DS. Ureteral stent insertion in the management of renal colic during pregnancy. Chonnam Med J 2016;
52: 123-127.
- Ramsey S, Robertson A, Ablett MJ, Meddings RN, Hollins GW,
Little B. Evidence-based drainage of infected hydronephrosis
secondary to ureteric calculi. J Endourol 2010; 24: 185-189.
- Lynch MF, Anson KM, Patel U. Percutaneous nephrostomy
and ureteric stent insertion for acute renal deobstruction: consensus based guidance. Br J Med Surg Urol 2008; 1: 120-125.
- Hill CC, Pickinpaugh J. Physiologic changes in pregnancy. Surg
Clin North Am 2008; 88: 391-401, vii.
- Ringel A, Richter S, Shalev M, Nissenkorn I. Late complications of ureteral stents. Eur Urol 2000; 38: 41-44.
- Zheng W, Denstedt JD. Intracorporeal lithotripsy: update on
technology. Urol Clin North Am 2000; 27: 301-313.
- Tsai YL, Seow KM, Yieh CH, Chong KM, Hwang JL, Lin YH,
Huang LW. Comparative study of conservative and surgical
management for symptomatic moderate and severe hydronephrosis in pregnancy: a prospective randomized study. Acta
Obstet Gynecol Scand 2007; 86: 1047-1050.
- Goldfarb RA, Neerhut GJ, Lederer E. Management of acute
hydronephrosis of pregnancy by ureteral stenting: risk of stone
formation. J Urol 1989; 141: 921-922.
- Peer A, Strauss S, Witz E, Manor H, Eidelman A. Use of percutaneous nephrostomy in hydronephrosis of pregnancy. Eur J
Radiol 1992; 15: 220-223.
- Tschada R, Mickisch G, Hettenbach A, Wischnik W, Alken P.
Internal urinary diversion in complicated pregnancy-induced
hydronephrosis. Z Geburtshilfe Perinatol 1992; 196: 123-128.
- Zwergel T, Lindenmeir T, Wullich B. Management of acute
hydronephrosis in pregnancy by ureteral stenting. Eur Urol
1996; 29: 292-297.
- Sahin H, Bircan MK, Yayla M. JJS application in acute symptomatic hydronephrosis in pregnancy. Int J Gynaecol Obstet
1997; 59: 141-142.
- Fainaru O, Almog B, Gamzu R, Lessing JB, Kupferminc M. The
management of symptomatic hydronephrosis in pregnancy.
BJOG 2002; 109: 1385-1387.
- Navalon Verdejo P, Sanchez Ballester F, Pallas Costa Y, Canovas
Ivorra JA, Ordono Dominguez F, Juan Escudero J, De la Torre
Abril L, Ramos de Campos M. Symptomatic hydronephrosis
during pregnancy. Arch Esp Urol 2005; 58: 977-982.
- vanSonnenberg E, Casola G, Talner LB, Wittich GR, Varney
RR, D’Agostino HB. Symptomatic renal obstruction or urosepsis during pregnancy: treatment by sonographically guided
percutaneous nephrostomy. AJR Am J Roentgenol 1992; 158:
91-94.
- Trewhella M, Reid B, Gillespie A, Jones D. Percutaneous nephrostomy to relieve renal tract obstruction in pregnancy. Br J
Radiol 1991; 64: 471-472.
- Khoo L, Anson K, Patel U. Success and short-term complication rates of percutaneous nephrostomy during pregnancy. J
Vasc Interv Radiol 2004; 15: 1469-1473.
- Nuri Bodakci M, Kemal Hatipoglu N, Ozler A, Turgut A, Hamidi C, Hatipoglu N, Bircan A. Hydronephrosis during pregnancy: how to make a decision about the time of intervention?
Med Glas (Zenica) 2014; 11: 165-169.
- Atar M, Bozkurt Y, Soylemez H, Penbegul N, Sancaktutar AA,
Bodakci MN, Hatipoglu NK, Hamidi C, Ozler A. Use of renal
resistive index and semi-rigid ureteroscopy for managing symptomatic persistent hydronephrosis during pregnancy. Int J
Surg 2012; 10: 629-633.
- Simonsen JA, Graumann O, Toft A, Henriques CU, Walter S.
Diagnosis and treatment of symptomatic hydronephrosis in
pregnancy. Ugeskr Laeger 2015; 177: V06140360.