Ureteral stent placement in hydronephrosis during pregnancy

In this study we describe 22 cases of retrograde ureteral stent placement i n pregnant women with therapy-resistant flank pain due to hydronephrosis. E leven were primiparous and one patient expected twins. Eight of 22 patients presented symptoms of pyelonephritis. In 21 cases the hydronephrosis was l ocated on the right and in 4 cases it was bilateral. Maximal lower calix di ameter was 12 mm (range 9-22 mm). With the exception of two cases, sonograp hically controlled stent placement was performed under local anesthesia wit hout sedation. All patients were painfree within 6 days and were given prop hylactic low dosis of antibiotic until the day of delivery. Renal function remained within the normal limits. Double-J stent displacement occured in 3 patients - of which one underwent nephrostomy. Postnatal examination demon strated urolithiasis in 4 of 19 patients. This study provides evidence for effectiveness of retrograde ureteral Double-J stent placement as a therapeu tic option in cases of severe symptomatic hydronephrosis during pregnancy w ith a low morbidity rate.