Symptomatic renal obstruction or urosepsis during pregnancy: treatment by sonographically guided percutaneous nephrostomy.

vanSonnenberg, Eric; Casola, G; Talner, Lee B.; Wittich, G R; Varney, R R; D'Agostino, H B

doi:10.2214/ajr.158.1.1727366

Cited by 62 publications

(34 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These studies have demonstrated that DJS is an effective and safe method for the treatment of pregnancy hydronephrosis. Percutaneous nephrostomy has been performed in a small number of cases in a few studies and successful results have been reported (19,(24)(25)(26). Most recently, Khoo et al assessed the shortterm complications and success rate of percutaneous nephrostomy during pregnancy (27).…”

Section: Discussionmentioning

confidence: 99%

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

2018

Turk J Med Sci

View full text Add to dashboard Cite

Background/aim: We aimed to compare the success rate of percutaneous nephrostomy (PCN) and double J stenting (DJS) in the treatment of symptomatic pregnancy hydronephrosis.Materials and methods: Diagnosis and grading of hydronephrosis were performed by urinary ultrasound (USG) and Doppler mode was used for evaluation of renal arterial resistivity index (RI). Patients were divided into two groups according to the method used for the 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 intervention was 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 those who underwent PCN (5/11 vs. 1/11, P = 0.0012). The time to tertiary intervention was longer in patients with PCN than in those with DJS (P = 0.0048). Conclusion:PCN may be preferred to DJS in symptomatic pregnancy hydronephrosis because it requires fewer re-interventions after longer times.

show abstract

Section: Discussionmentioning

confidence: 99%

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

2018

Turk J Med Sci

View full text Add to dashboard Cite

show abstract

“…Vansonnenberg, et al [9] reported their experience in treating seven pregnant women whose ages ranged between 19 years and 31 years who had pyosepsis and dilatation of the upper urinary tract who were successfully treated by means of ultra-sound scan guided percutaneous nephrostomy. The immediate improvement in five patients who were ill because of pyosepsis was dramatic.…”

Section: Discussionmentioning

confidence: 99%

“…On the whole 9 percutaneous nephrostomies and 3 tube exchanges were performed in seven pregnant women. Vansonnenberg, et al [9] stated that prior to their report, earlier reports that focused on noninfected ureteric obstruction during pregnancy had recommended retrograde insertion of ureteric stents and fluoroscopic guided insertion of percutaneous nephrostomy.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Nephrostomy in pregnancy a district general hospital experience over five years

Venyo

Fatola

Adegbite

et al. 2014

JBGC

View full text Add to dashboard Cite

Background: Obstructed kidney is also termed hydronephrosis. An obstructed kidney produces buildup of urine within the kidney which increases pressure within the kidney. This condition can be a result of several different causes of which pregnancy is one of them. Obstructed kidneys in pregnancy call for relieving by nephrostomy which is a thin, plastic tube (catheter) that is inserted through the skin on the back and into the kidney. It can relieve a build-up of urine in the kidney and prevents the kidney from being damaged. It drains urine directly from one or both kidneys into a collecting bag outside the body. The bag has a tap so it can be emptied. Aims: To find out the rate of nephrostomy tube insertion in pregnant women in North Manchester General Hospital between January 2009 -December 2013. To identify problems that emanated from insertion of the nephrostomies. Results: Fifteen patients out of 24,863 deliveries (0.06%) in our catchment area underwent 17 nephrostomy procedures. All the nephrostomy insertions were successfully and safely undertaken. There was no immediate complication. The complications that were noted include: subsequent blockage of nephrostomy tubes which required readmission to flush the tubes to render them patent, two nephrostomy tubes subsequently fell out which were replaced, there was 1 minor infection which was treated by oral antibiotics. Surgical causes of obstruction found at post-partum nephrostogram include calculi and ureteric strictures which were managed post-partum. All the pregnancies continued to full-term with delivery of normal full-term babies. Conclusions: Percutaneous nephrostomy insertion in the pregnant woman under ultra-sound scan guidance is a safe and effective procedure associated with minimal complications and this allows pregnancy to continue to full term. The fact that the blocked nephostomies could all be flushed easily to unblock the tubes would indicate that if all district nurses are taught how to carefully flush nephrostomies readmission with blocked nephrostomies would be minimised. Strict adherence to nephrostomy protocol would partly help reduce complications associated with nephrostomy insertion in pregnancy.

show abstract

“…Insertion of percutaneous nephrostostomy (PCN) has been advocated in patients with symptomatic hydronephrosis associated with spontaneous extravasation of urine [2], urosepsis and azotemia [11] while ureteroscopic removal of stone only in selected cases [1].…”

Section: Discussionmentioning

confidence: 99%

Management of Acute Symptomatic Hydronephrosis of Pregnancy by Postural Drainage

Chitale¹,

Chitale²

2010

TOUNJ

View full text Add to dashboard Cite

Introduction & Objectives:Asymptomatic hydronephrosis is found in >90% of pregnant women, only a small proportion become symptomatic. Non-surgical management is the treatment of choice. In refractory cases surgical intervention is indicated.We present our experience with conservative management of acute symptomatic hydronephrosis of pregnancy by facilitating postural drainage of the obstructed symptomatic kidney.Material & Methods: 1750 women with full term pregnancy were managed in the unit over 5 yrs. 130 (7.4%) presented with unilateral loin pain and were in the third trimester of pregnancy at presentation (20@ 28 weeks, 58@ 30 weeks, and 52@ 32 weeks). 68 / 130 (52.3%) were multi-parous. Age range was 26-38 yrs.115 (88.5%) presented with right-sided loin pain and 15 (11.5%) had pain in the left loin. There was no evidence of incipient urinary tract infection (UTI). Ultrasound scan (USS) confirmed presence of ipsilateral mild to moderate hydronephrosis with no evidence of renal / ureteric calculus.All were refractory to routine enteral or parenteral analgesia over 72 hrs.They were managed in a semi-prone position while in bed, with the affected side up and non-dependant. Head end of their bed was kept raised by 10º throughout this period of conservative management; initiated in the hospital and continued at home until term.Results: 121 of the 130 women (93.1%) had symptomatic improvement. None required regular analgesia and went to term without further intervention i.e. insertion of nephrostomy / stenting. Follow-up USS at three months post-partum revealed complete resolution of hydronephrosis.Conclusions: Postural drainage of the kidney is highly effective in the management of acute symptomatic hydronephrosis of pregnancy. In the majority of cases (93%), if used diligently, it will help prevent the need for invasive uro-radiological intervention.

show abstract

Symptomatic renal obstruction or urosepsis during pregnancy: treatment by sonographically guided percutaneous nephrostomy.

Cited by 62 publications

References 0 publications

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

Nephrostomy in pregnancy a district general hospital experience over five years

Management of Acute Symptomatic Hydronephrosis of Pregnancy by Postural Drainage

Contact Info

Product

Resources

About