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Ureteral Disorders During Pregnancy

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The Ureter

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Abstract

Symptomatic maternal hydronephrosis is a common obstetric complaint during pregnancy and should be differentiated from non-symptomatic hydronephrosis. Renal colic due to obstructive ureteral stones during pregnancy is another medical problem that could be difficult in diagnosis and treatment. Many advanced diagnostic methods are available for the evaluation of renal colic and urolithiasis accurately and safely during pregnancy. The management of symptomatic hydronephrosis and urolithiasis is a challenge for obstetricians and urologists. A multidisciplinary medical team is often necessary for the evaluation and management of pregnant patients with acute urolithiasis and urinary tract obstruction. Conservative treatment usually is very successful in a higher proportion of cases, however, failed medical management requires an interventional procedure to relieve kidney obstruction, overcome the possibility of urosepsis and reduce obstetric complications. Many clinical algorithms have been proposed for the management of renal colic and urolithiasis during pregnancy. However, the clinician should intervene with minimally invasive surgical procedures at the proper time.

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Abbreviations

CT:

Computed tomography

DJ:

Double J

MET:

Medical expulsive therapy

MRI:

Magnetic resonance imaging

MRU:

Magnetic resonance urography

PCNL:

Percutaneous nephrolithotomy

RI:

Resistive index

SWL:

Shock wave lithotripsy

TVUS:

Transvaginal ultrasound

URS:

Ureteroscopy

US:

Ultrasound

UTI:

Urinary tract infection

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Author information

Authors and Affiliations

  1. Toshka Urology and Endoscopy Center, Mansoura, Egypt

    Mahmoud Abdel-Gawad

Authors
  1. Mahmoud Abdel-Gawad
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Editor information

Editors and Affiliations

  1. Belqas, Elnagar Urology Center, Mansoura City, Egypt

    Mahmoud Abdel-Gawad

  2. Urology Department, Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Bedeir Ali-El-Dein

  3. Department of Urology and Department of Surgery, Oregon Health & Science University, Portland, OR, USA

    John Barry

  4. Department of Urology, Universitatsklinikum Tubingen, Tübingen, Baden-Württemberg, Germany

    Arnulf Stenzl

Questions

Questions

  1. 1.

    The following medications are not contraindicated during pregnancy except:

    1. (a)

      Codeine

    2. (b)

      Nifedipine

    3. (c)

      Tamsulosin

    4. (d)

      Tramadol

    5. (e)

      Acetaminophen

    Answer: (d)

  2. 2.

    The following are indications for the active invasive procedure during pregnancy except:

    1. (a)

      Obstructed solitary kidney

    2. (b)

      Urosepsis

    3. (c)

      Bilateral obstructed kidneys

    4. (d)

      Impaired renal function

    5. (e)

      Heavy pyuria

    Answer: (e)

  3. 3.

    The following are not contraindicated radiological investigations during pregnancy except:

    1. (a)

      Transvaginal ultrasound

    2. (b)

      NCCT

    3. (c)

      MRU

    4. (d)

      Ultra-CT

    5. (e)

      KUB

    Answer: (b)

  4. 4.

    The following procedure is could be done during pregnancy except:

    1. (a)

      PCN

    2. (b)

      URS

    3. (c)

      ESWL

    4. (d)

      PCNL

    5. (e)

      JJ stent

      Answer: (c)

  5. 5.

    Which of the following statement is incorrect:

    1. (a)

      Gestational hydronephrosis is more common on the right side than on the left.

    2. (b)

      Hydronephrosis is a symptomatic in most pregnant patients

    3. (c)

      The left hydronephrosis usually indicates the presence of ureteral stone

    4. (d)

      Most symptomatic hydronephrosis can be managed conservatively

    5. (e)

      Most of the ureteral stones are in the upper ureter

      Answer: (e)

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Abdel-Gawad, M. (2023). Ureteral Disorders During Pregnancy. In: Abdel-Gawad, M., Ali-El-Dein, B., Barry, J., Stenzl, A. (eds) The Ureter . Springer, Cham. https://doi.org/10.1007/978-3-031-36212-5_24

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  • DOI: https://doi.org/10.1007/978-3-031-36212-5_24

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-36211-8

  • Online ISBN: 978-3-031-36212-5

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