Acute urological Diseases in Pregnancy and their Treatment in Our Clinical Material

Overview

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. 40women (62%) were primiparas. 54 patients (83%) had infection of urinary tract (IUT). One patientwas 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 antibioticsand endoprothesis and another one with ureterolithiasis (1,5%) in lower ureter by ureteroscopicmethod. Renal colic was present in 43 (66%) patients (more often on the right side 3,3:1), whileurolithiasis was confirmed only in 14 (21%) of them. 52 (80%) women had dilatation of upperurinary tract (UUT) - more often on the right side (3,3:1). The correlation between the dilatationof UUT and acute PNF was confirmed. As for treatment of obstruction of UUT the drenage byurethral catheter (2 - 6 days, on average 3 days) was used in 14 (22 %) women and long-termdrenage (pig tail, double JJ stent) was used in 5 (8%) patients. Patients with IUT and PNF weretreated 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 pregnancywith 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 ofconservative 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