Functional hydronephrosis complicated by urolithiasis in a pregnant woman

Abstract

Objective: To optimise approaches to the diagnosis and management of pregnant women with obstructive uropathy caused by urolithiasis.
Materials and methods: We analysed the pregnancy and delivery of a woman with obstructive uropathy due to urinary stone disease.
Results: The patient underwent multiple percutaneous nephrostomy tube replacements due to internal obstruction. During the postpartum period, computed tomography (CT) of the kidneys revealed incrustation of the internal ureteral stent on the right. Additionally, a dense structure measuring 10.4 × 3.5 mm and exhibiting a Hounsfield unit value of 360 was identified in the lower third of the right ureter. According to the literature, most authors recommend replacing nephrostomy drainage 2–3 months after placement. However, we would like to add that standard schedules and timing for elective replacement of drainage systems should be strictly individualised, considering both the patient’s anatomical and physiological features, as well as her attitudes towards the pathological process.
Conclusions: To prevent complications in pregnant women with urinary stone disease and ensure successful treatment, it is essential to carefully determine the type of upper urinary tract drainage (ureteral stent or nephrostomy) and perform regular ultrasound examinations to clarify the condition and position of the installed drain.