Urology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.
Urology Department, 'C.I. Parhon' University Hospital, 700115 Iasi, Romania.
Medicina (Kaunas). 2022 Apr 29;58(5):619. doi: 10.3390/medicina58050619.
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.
微创治疗方法，如双 J 输尿管支架置入术，可能是治疗梗阻性尿路病变的一种有前途的保守治疗替代方法。我们旨在评估双 J 输尿管支架置入术在患有输尿管积水或尿路结石的孕妇中的安全性和有效性，以及其感染并发症，并将该患者队列的妊娠结局与对照组进行比较。
这项观察性回顾性研究包括在罗马尼亚雅西的“C.I. Parhon”大学医院泌尿科接受双 J 输尿管支架置入术治疗泌尿系统疾病的 52 名孕妇，并在一家三级妇产医院“Cuza-Voda”进行随访。对照组（63 名患者）是从同一时期在该妇产医院分娩的患者队列中随机选择的，没有尿路疾病。检查了临床、超声和实验室变量。使用描述性统计、非参数检验和一对一倾向评分匹配分析来分析我们的数据。
单变量分析表明，对照组和介入组之间在产妇年龄（p = 0.018）、产妇肾结石病史（p = 0.005）或肾结石病史（p = 0.002）方面存在显著统计学差异。在应用倾向评分匹配分析后，剖宫产率（p < 0.001）、早产（p = 0.039）、胎膜早破（p = 0.026）、早产率（p = 0.002）和产后尿路感染率（p = 0.012））在对照组和匹配治疗组之间有显著差异。单纯性（n = 37；71.2%）或感染性（n = 13；25%）输尿管积水是双 J 输尿管支架置入术的主要适应证。在随访期间记录了一些并发症，如疼痛（n = 21；40.3%）、支架移位（n = 3；5.76%）或结石形成（n = 2；3.84%），以及反流性肾盂肾炎（n = 2；3.84%）和肉眼血尿（n = 1；1.92%）。
我们的结果表明，双 J 支架置入术是治疗梗阻性泌尿系统疾病孕妇的一种安全有效的治疗选择。
