Blanco Leonardo Tortolero, Socarras Moises Rodriguez, Montero Rubén Fabuena, Diez Elena López, Calvo Antonio Ojea, Gregorio Sergio Alonso Y, Cansino José Ramón, Galan Juan Antonio, Rivas Juan Gómez
Vinalopó University Hospital, Department of Urology, Alicante, Spain.
A.C. University Hospital Vigo, Department of Urology, Vigo, Spain.
Cent European J Urol. 2017;70(1):93-100. doi: 10.5173/ceju.2017.754. Epub 2016 Oct 28.
Renal colic during pregnancy is a rare urgency but is one of the most common non-obstetric reasons for hospital admission. The management often means a challenge for the urologist and gynecologist due to the complexity involved in preserving the maternal and fetal well-being.
We performed a literature search within the PubMed database. We found 65 related articles in English. We selected 36 for this review prioritizing publications in the last two decades.
The anatomical and functional changes of the genitourinary system during pregnancy are well documented; also during pregnancy, there are several metabolic pro-lithogenic factors. The most common clinical presentation is flank pain accompanied by micro or macro hematuria. US provides data identifying renal obstruction shown by an increased renal resistance index. MRI allows differentiating the physiological dilatation from the pathological caused by an obstructive stone showing peripheral renal edema and renal enlargement. Low dose CT has been determined to be a safe and highly accurate imaging technique. Once the diagnosis is confirmed, the initial management of patients should be conservative. When conservative management fails the interventional treatment is mandatory, a urinary diversion of the obstructed renal unit either by a JJ stent or through a PCN catheter has to be done. The definitive management of the stone can be done in the postpartum or deferred ureteroscopy can be considered during pregnancy.
Renal colic during pregnancy is an uncommon urgency, so it is important for the urologist to know the management of this condition.
孕期肾绞痛虽不常见，但却是住院最常见的非产科原因之一。由于在保障母婴健康方面存在复杂性，其治疗对泌尿外科医生和妇科医生而言往往是一项挑战。
我们在PubMed数据库中进行了文献检索。共找到65篇英文相关文章。我们选择了36篇进行本次综述，优先考虑过去二十年的出版物。
孕期泌尿生殖系统的解剖和功能变化已有充分记录；孕期还存在多种促结石形成的代谢因素。最常见的临床表现是胁腹痛伴镜下或肉眼血尿。超声可提供数据，通过肾阻力指数升高识别肾梗阻。磁共振成像（MRI）能够区分生理性扩张与由梗阻性结石导致的病理性扩张，后者表现为肾周水肿和肾脏增大。低剂量计算机断层扫描（CT）已被确定为一种安全且高度准确的成像技术。一旦确诊，患者的初始治疗应采取保守治疗。当保守治疗失败时，介入治疗是必要的，必须通过双J管或经皮肾穿刺造瘘（PCN）导管对梗阻的肾单位进行尿液引流。结石的最终治疗可在产后进行，或者在孕期可考虑延期输尿管镜检查。
孕期肾绞痛是一种不常见的急症，因此泌尿外科医生了解这种病症的治疗方法很重要。
