Tschada R, Mickisch G, Hettenbach A, Wischnik W, Alken P
Urologische Klinik, Fakultät für klinische Medizin, Universität Heidelberg.
Z Geburtshilfe Perinatol. 1992 May-Jun;196(3):123-8.
In 14 women with sympthomatic hydronephrosis of pregnancy (calix diameter 1-2.6 cm) an internal urinary drainage was carried out during the second half of pregnancy. Retrograde stenting was performed following cystoscopy in all cases. Follow up examinations were taken weekly for the first two weeks and further on biweekly. Primary stenting was possible in 12 out of 14 cases and in 2 patients dilatation of the ureteral orifice was necessary. 11 out of 14 patients suffered from complications consisting of severe dysuria (9x), urinary tract infection (7x), persisting lumbar pain plus catheter lumen obstruction (6x each) as well as catheter dislocation (3x). Long term follow up showed that urinary tract obstruction was relieved by stenting in only 6 out of 14 patients. Sufficient urinary drainage by so called double-J-ureteral stents was achieved in less than half of the cases. Moreover, there was a complication rate of more than 75%. Taking these results into consideration, internal drainage of complicated pregnancy hydronephrosis needs careful evaluation.
在14例有症状的妊娠肾积水(肾盂直径1 - 2.6厘米)的女性患者中,于妊娠后半期进行了内引流术。所有病例均在膀胱镜检查后进行逆行支架置入。最初两周每周进行随访检查,之后每两周进行一次。14例中有12例可以进行初次支架置入,2例患者需要扩张输尿管口。14例患者中有11例出现并发症,包括严重排尿困难(9例)、尿路感染(7例)、持续腰痛加导管腔阻塞(各6例)以及导管移位(3例)。长期随访显示,14例患者中只有6例通过支架置入缓解了尿路梗阻。不到一半的病例通过所谓的双J输尿管支架实现了充分的尿液引流。此外,并发症发生率超过75%。考虑到这些结果,复杂妊娠肾积水的内引流需要仔细评估。