Pregnancy Outcomes in a Cohort of Patients Who Underwent Double-J Ureteric Stenting—A Single Center Experience

Abstract

Background and Objectives: Minimally invasive procedures, such as double-J ureteric stenting, could be a promising therapeutic alternative to conservative management of obstructive urinary tract pathology. We aimed to evaluate the safety and effectiveness of double-J ureteric stenting in pregnant women with ureterohydronephrosis or urolithiasis, along with their infectious complications, and to assess the pregnancy outcomes of this cohort of patients in comparison with a control group. Materials and Methods: This observational retrospective study included 52 pregnant patients who underwent double-J ureteric stenting for urologic disorders in the Urology Department of ‘C.I. Parhon’ University Hospital, and who were followed up at a tertiary maternity hospital- ‘Cuza-Voda’, Iasi, Romania. The control group (63 patients) was randomly selected from the patient’s cohort who gave birth in the same time frame at the maternity hospital, without urinary pathology. Clinical, sonographic, and laboratory variables were examined. Descriptive statistics, non-parametric tests, and a one-to-one propensity score-matched analysis were used to analyze our data. Results: The univariate analysis indicated a significant statistical difference between the control group and the interventional group regarding maternal age (p = 0.018), previous maternal history of renal colic (p = 0.005) or nephrolithiasis (p = 0.002). After applying the propensity score-matched analysis, cesarean delivery rates (p < 0.001), preterm labour (p = 0.039), premature rupture of membranes (p = 0.026), preterm birth rates (p = 0.002), and post-partum UTI rates (p = 0.012) were significantly different between the control group and the matched treatment group. Ureterohydronephrosis, whether simple (n = 37; 71.2%) or infected (n = 13; 25%), was the main indication for double-J ureteric stenting. Complications such as pain (n = 21; 40.3%), stent migration (n = 3; 5.76%) or encrustation (n = 2; 3.84%), as well as reflux pyelonephritis (n = 2; 3.84%) and gross hematuria (n = 1; 1.92%) were recorded during follow-up. Conclusions: Our results show that double-J stenting is a safe and effective treatment option for pregnant patients with obstructive urological disorders.

Efficacy and Safety of Extracorporeal Shock Wave Lithotripsy (ESWL) in Patients With Infected Ureterohydronephrosis Due to Ureteral Stones Following Double-J Catheter Insertion

“…Reflux pyelonephritis can be a serious complication that can quickly lead to urosepsis in the absence of adequate antibiotic treatment [30]. However, as in other studies [28,31], the incidence of symptoms associated with double-J catheters in our study was much lower than the nearly 80% reported in other studies [13,25]. We did not find, as reported in other studies [32], that multiple ESWL sessions are required in patients with double-J stents to achieve the same effect as in patients without stents.…”

Pregnancy Outcomes in Patients with Urosepsis and Uncomplicated Urinary Tract Infections—A Retrospective Study

“…Moreover, the time interval between the onset of urinary symptoms and hospital admission for further investigations was higher for patients with urosepsis compared to patients with uncomplicated UTIs. All these are known risk factors for developing UTIs in pregnancy [6,51], and we hypothesize that the longer timeframe until admission to the urology department in the case of patients with urosepsis constitutes an important aggravating factor.…”

“…Several risk factors and physiologic changes in pregnancy play an important role in the development and spread of UTIs. The current literature has identified as predisposing factors for UTIs the following: ethnicity, advanced maternal age, multiparity, hydronephrosis in pregnancy, personal history of UTI, immunosuppressive conditions (e.g., diabetes mellitus), anemia, smoking, and low educational level or socioeconomic status [5,6].…”

Factors Associated with Increased Risk of Urosepsis during Pregnancy and Treatment Outcomes, in a Urology Clinic

“…We found no maternal deaths in either group. However, despite the efficacy and safety of urologic maneuvers [37], complications and increased incidence of fetal distress and the need for transfer to a maternity hospital should not be neglected. In contrast, pregnant women without urosepsis did not experience fetal distress requiring transfer [14].…”