Acerca de la hidronefrosis sintomática en la gestante

Abstract

OBJECTIVES: Hydronephrosis is common during pregnancy, affecting 90% of pregnant women. It is usually asymptomatic, but a small percentage of patients show clinical symptoms requiring treatment. We want to report our experience in the diagnosis and treatment of symptomatic obstructive uropathy in pregnant women. METHODS: We retrospectively evaluate the results obtained in 162 pregnant women suffering symptomatic hydronephrosis who received care at our department over the last 12 years. RESULTS: Conservative treatment was effective in most patients, 39 patients required more aggressive therapy. Thirty-five patients underwent insertion of a double J catheter, 2 patients percutaneous nephrostomy, and another 2 ureteroscopy and extraction of ureteral lithiasis. CONCLUSIONS: The most frequent etiology of symptomatic hydronephrosis during pregnancy is external compression by the gravid uterus, followed by ureteral lithiasis. We consider conservative treatment as the treatment of choice, leaving ureteral double J catheter insertion or percutaneous nephrostomy for the refractory cases. Ureteroscopy is a new diagnostic and therapeutic option when other less aggressive measures fail.