Ureteral stent insertion in pregnants with intractable flank pain: A clinical experience

Can, Utku

doi:10.14744/scie.2018.26349

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…Current trends reveal that the number of obstructive uropathy cases such as those caused by kidney stones that involve a 10% lifetime prevalence is on the rise while increasing instances of hospitalisation. , Several factors can cause obstructive uropathy, but the most prominent one is the presence of stones in the urinary system including kidneys, ureter, and bladder. Other health conditions and disorders that can induce obstructive uropathy include pregnancy, , retroperitoneal fibrosis, cancer of the prostate gland, spinal cord injury, stricture inside the ureter generally developed following accumulation of scar tissue or swelling around the ureter, endometriosis with ureteral involvement, , and a multitude of other causes both benign and malignant. If any of these conditions is left neglected, it can result in ureteral blockage, and if severe, can stop drainage of the urine from kidney to bladder, leading to accumulation of urine in the kidney.…”

Section: Introductionmentioning

confidence: 99%

Electromechanically Functionalized Ureteral Stents for Wireless Obstruction Monitoring

Darestani

Lange

Chew

et al. 2023

ACS Biomater. Sci. Eng.

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While millions of ureteral stents are placed in patients with urinary tract issues around the world every year, hydronephrosis still poses great danger to these patients as a common complication. In the present work, an intelligent double-J ureteral stent equipped with a micro pressure sensor and antenna circuitry is investigated and prototyped toward enabling continuous wireless monitoring of kidney pressure to detect a ureteral obstruction and the resultant hydronephrosis via the indwelling stent. This electromechanically functionalized “intelligent” ureteral stent acts as a radiofrequency resonator with a pressure-sensitive resonant frequency that can be interrogated using an external antenna to track the local pressure. The prototype passes mechanical bending tests of up to 15 cm radius of curvature and shows wireless sensing with a sensitivity of 3.1 kHz/mmHg in artificial urine, which represents 25× enhancement over the preceding design, using an in vitro model with test tissue layers and a pressure range that functions within the conditions found in hydronephrotic conditions. These promising results are expected to propel intelligent ureteral stent technology into further clinical research.

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Section: Introductionmentioning

confidence: 99%

Electromechanically Functionalized Ureteral Stents for Wireless Obstruction Monitoring

Darestani

Lange

Chew

et al. 2023

ACS Biomater. Sci. Eng.

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“…In addition, studies looking at the efficacy and safety of the upper urinary drainage during pregnancy (e.g., by insertion of a double-J catheter or percutaneous nephrostomy) [16][17][18][19], which is the primary urologic treatment for urosepsis along with antibiotic therapy, have primarily considered pregnancy-related hydronephrosis and renal ureteral lithiasis as indications for urologic treatment but have not examined the effects of treatment in cases of urinary tract obstruction with superinfection and urosepsis.…”

Section: Introductionmentioning

confidence: 99%

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

Radu,

Costache,

Onofrei

et al. 2023

Medicina

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Background and Objectives: Urosepsis is a significant cause of maternal and fetal mortality. While certain risk factors for urinary tract infections (UTIs) in pregnant women are well established, those associated with an elevated risk of urosepsis in pregnant women with upper UTIs remain less defined. This study aims to identify factors linked to an increased risk of urosepsis and examine urologic treatment outcomes in such cases. Materials and Methods: We conducted a retrospective analysis on 66 pregnant women diagnosed with urosepsis over a nine-year period. A control group included 164 pregnant women with upper UTIs, excluding urosepsis, admitted during the same timeframe. This study highlights factors potentially contributing to urosepsis risk, including comorbidities like anemia, pregnancy-related hydronephrosis or secondary to reno-ureteral lithiasis, prior UTIs, coexisting urological conditions, and urologic procedures. Outcomes of urologic treatments, hospitalization duration, obstetric transfers due to fetal distress, and complications associated with double-J catheters were analyzed. Results: Pregnant women with urosepsis exhibited a higher prevalence of anemia (69.7% vs. 50.0%, p = 0.006), 2nd–3rd grade hydronephrosis (81.8% vs. 52.8%, p = 0.001), and fever over 38 °C (89.4% vs. 42.1%, p = 0.001). They also had a more intense inflammatory syndrome (leukocyte count 18,191 ± 6414 vs. 14,350 ± 3860/mmc, p = 0.001, and C-reactive protein (CRP) 142.70 ± 83.50 vs. 72.76 ± 66.37 mg/dL, p = 0.001) and higher creatinine levels (0.77 ± 0.81 vs. 0.59 ± 0.22, p = 0.017). On multivariate analysis, factors associated with increased risk for urosepsis were anemia (Odds Ratio (OR) 2.622, 95% CI 1.220–5.634), 2nd–3rd grade hydronephrosis (OR 6.581, 95% CI 2.802–15.460), and fever over 38 °C (OR 11.612, 95% CI 4.804–28.07). Regarding outcomes, the urosepsis group had a higher rate of urological maneuvers (87.9% vs. 36%, p = 0.001), a higher rate of obstetric transfers due to fetal distress (22.7% vs. 1.2%, p = 0.001), and migration of double-J catheters (6.1% vs. 0.6%, p = 0.016), but no maternal fatality was encountered. However, they experienced the same rate of total complications related to double-J catheters (19.69% vs. 12.80%, p > 0.05). The pregnant women in both groups had the infection more frequently on the right kidney, were in the second trimester and were nulliparous. Conclusions: Pregnant women at increased risk for urosepsis include those with anemia, hydronephrosis due to gestational, or reno-ureteral lithiasis, and fever over 38 °C. While the prognosis for pregnant women with urosepsis is generally favorable, urological intervention may not prevent a higher incidence of fetal distress and the need for obstetric transfers compared to pregnant women with uncomplicated upper UTIs.

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Ureteral stent insertion in pregnants with intractable flank pain: A clinical experience

Cited by 2 publications

References 24 publications

Electromechanically Functionalized Ureteral Stents for Wireless Obstruction Monitoring

Electromechanically Functionalized Ureteral Stents for Wireless Obstruction Monitoring

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

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