MANAGEMENT OF RENAL COLIC DURING PREGNANCY

Authors

  • Irina NEGRU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Alexandra PANGAL “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • C. PRICOP “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Elena MIHALCEANU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • G. COSTACHESCU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • D. NEGRU “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Abstract

The diagnosis of urological diseases in pregnancy involves particularities requiring both the knowledge of the pathophysiological mechanisms of the respective diseases and a experience of the urologist and gynecologist in assessing the physiological conditions of pregnancy. Aim: To identify the specific features of renal colic in pregnant women, in the context in which the urological assessment of them is not mandatory. Material and methods: The study included a group of 86 pregnant women diagnosed with urological diseases and renal colic as their main symptom. Results: There are two major difficulties faced by urologists in these cases: firstly, the impossibility of conducting X-ray imaging investigations to determine the location and type of the obstruction and, on secondly, the ureteral catheterization and insertion of the ureteral catheter in the absence of adequate fluoroscopic control. Conclusions: The urologist's experience is decisive in establishing intraoperatively if the introduction of the ureteric probe is possible, the risk of a ureteral perforation with severe consequences requiring a percutaneous nephrostomy to be performed under ultrasound guidance.

Author Biographies

  • Irina NEGRU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Surgery (II)

  • Alexandra PANGAL, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Mother and Child Medicine

  • C. PRICOP, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Surgery (II)

  • Elena MIHALCEANU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Mother and Child Medicine

  • G. COSTACHESCU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Mother and Child Medicine

  • D. NEGRU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

    Faculty of Medicine
    Department of Surgery (II)

References

1. Loughlin KR. Management of urologic problems during pregnancy. Humana Press Inc., 2004, 1-3.
2. Dominique RM, Kimberly LF, Benjamin MB,Urologic and Gynecologic Sources of Pelvic Pain. Physical Medicine and Rehabilitation Clinics of North America 2017; 28(3): 571-588.
3. Stanton SL, Kerr-Wilson R, Harris GV. The incidence of urological symptoms in normal pregnancy. Br J Obstet Gynaecol 1980; 87: 897-900.
4. Gorton E, Whitfield HN. Renal calculi in pregnancy. Br J Urol1997; 80(Suppl 1): 4-9.
5. Lewis DF, Robichaux AG, Jaekle RK, et al. Urolithiasis in pregnancy. Diagnosis, management and pregnancy outcome. J Reprod Med 2003; 48: 28-32.
6. Dunlop, W, Davison, J.M.: Renal hemodynamics and tubular function in human pregnancy. Clin Obstet Gynaecol 1997; 1: 769-773.
7. Zavadovschi I. Pain as a late emotional reaction. Clinical research evaluating the psychosocial expres-sion of pain disorder in preoperative and postoperative period, Rev. Med. Chir. Soc. Med. Nat. Iasi 2014; 118(3): 706-711.
8. Grammatikakis S, Zervoudis S, Fotopoulos AB, Badiu C. Prevalence of maternal hypothyroidism complicated with preeclampsia: a retrospective analysis of 60 cases, Rev. Med. Chir. Soc. Med. Nat. Iasi 2017; 121(2): 253, 257-263.
9. Miron I, Diaconescu S, Aprodu G, Ioniuc I, Diaconescu MR, Miron L. Diagnostic difficulties in a pediatric insulinoma: a case report. Medicine 2016; 95(11): 3045.
10. Drago JR, Rohner TJ Jr, Chez RA. Management of urinary calculi in pregnancy. Urology1982; 20: 578-581.
11. Loughlin KR, Kerr LA. The current management of urolithiasis during pregnancy. Urol Clin North Am. 2002; 29: 701-704.
12. Hansen W, Moshiri M, Paladin A, Lamba R, Katz DS, Bhargava P. Evolving practice patterns in imaging pregnant patients with acute abdominal and pelvic conditions. Curr Probl Diagn Radiol 2017; 46: 10-16.
13. DubuissonV, Vorglio EJ, Grenier N, LeBras Y, Thoma M, Launay-Savary MV. Imaging of non-traumatic abdominal emergencies in adults. J Visc Surg 2015; 152: 57-64.
14. Masselli G, Derme M, Laghi F, Framarino-dei-Malatesta M, Gualdi G. Evaluating the acute abdomen in the pregnant patient. Radiol Clin North Am 2015; 53: 1309-1325.

Additional Files

Published

2018-04-04