Acute urological Diseases in Pregnancy and their Treatment in Our Clinical Material
Nagy, Valanský, Lukačín, Suchánek
Urologická klinika FNsP, Košice, prednosta doc. MUDr. L. Valanský, PhD., Gynekologicko-pododnická klinika FNsP, Košice, prednosta doc. MUDr. Š. Lukčín CSc. |
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Summary:
Objective: To evaluate results of treatment of acute urological diseases (AUD) in pregnancy.
Design: Retrospective clinical study.
Setting: Department of Urology and 1st Department of Gyneacology and Obstetrics, Faculty Hospital Košice.
Methods: 65 pregnant women with AUD aged 15-34 years (average 24 years) underwent gyneacolo-
gical and urological examination.
Results: The most often occurrence of AUD was in the 2nd and the 3rd trimester of pregnancy. 40
women (62%) were primiparas. 54 patients (83%) had infection of urinary tract (IUT). One patient
was treated for hemorrhagic cystitis. Acute pyelonephritis (PNF) was present in 38 (58%) women -
more often on the right side (4,4:1) and nephrolithiasis in 13 (20%) women. Because of the disagreement with operation one patient with calculous pyonephrosis (1,5%) was treated by antibiotics
and endoprothesis and another one with ureterolithiasis (1,5%) in lower ureter by ureteroscopic
method. Renal colic was present in 43 (66%) patients (more often on the right side 3,3:1), while
urolithiasis was confirmed only in 14 (21%) of them. 52 (80%) women had dilatation of upper
urinary tract (UUT) - more often on the right side (3,3:1). The correlation between the dilatation
of UUT and acute PNF was confirmed. As for treatment of obstruction of UUT the drenage by
urethral catheter (2 - 6 days, on average 3 days) was used in 14 (22 %) women and long-term
drenage (pig tail, double JJ stent) was used in 5 (8%) patients. Patients with IUT and PNF were
treated due to results of microbial culture, more often by cefalosporines or synthetic penicilins.
Complications during treatment did not occured.
Conclusion: AUD in pregnancy are very serious in the IInd and the IIIrd trimester of pregnancy
with disorders of urinary passage. Ultrasonography is unique method in diagnosis of dilatation of UUT and AUD. Obstructive form of acute PNF needs pressing derivation of urine. Due to limits of
conservative treatment instrumental intervention can solve also the complicated situations.
Key words: acute urological diseases, pregnancy, infection of urinary tract, pyelonephritis, urolit-
hiasis, renal colic, treatment
Key words:
acute urological diseases, pregnancy, infection of urinary tract, pyelonephritis, urolithiasis, renal colic, treatment
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