He MM, Lin XT, Lei M, Xu XL, He ZH. Does delaying ureteral stent placement lead to higher rates of preoperative acute pyelonephritis during pregnancy? World J Clin Cases 2022; 10(3): 802-810 [PMID: 35127896 DOI: 10.12998/wjcc.v10.i3.802]
Corresponding Author of This Article
Zhi-Hui He, PhD, Chief Doctor, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou Medical University, No. 151 Yanjiang West Road, Yuexiu District, Guangzhou 510120, Guangdong Province, China. 945523157@qq.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 21, 2022; 10(3): 802-810 Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.802
Does delaying ureteral stent placement lead to higher rates of preoperative acute pyelonephritis during pregnancy?
Mao-Mao He, Xiao-Ting Lin, Ming Lei, Xiao-Lan Xu, Zhi-Hui He
Mao-Mao He, Xiao-Ting Lin, Xiao-Lan Xu, Zhi-Hui He, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China
Ming Lei, Department of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China
Author contributions: He MM wrote the manuscript; He MM and Lin XT analyzed the data; Xu XL collected the data; Lei M and He ZH contributed to the protocol/project development; He ZH contributed to analysis, manuscript editing.
Supported byScience and Technology of Guangdong Province, No. 2017ZC0223; and Intra-Hospital Fund of the First Affiliated Hospital of Guangzhou Medical University, No. 20130A.
Institutional review board statement: The study was reviewed and approved by the First Affiliated Hospital of Guangzhou Medical University Institutional Review Board (Approval No. V1.0).
Informed consent statement: All study participants provided informed written consent prior to study enrolment.
Conflict-of-interest statement: No other sources of funding or conflicts of interest to disclose.
Data sharing statement: The dataset is available from the corresponding author at hemaomao1982@126.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Noncommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Hui He, PhD, Chief Doctor, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou Medical University, No. 151 Yanjiang West Road, Yuexiu District, Guangzhou 510120, Guangdong Province, China. 945523157@qq.com
Received: May 23, 2021 Peer-review started: May 23, 2021 First decision: June 15, 2021 Revised: June 28, 2021 Accepted: December 21, 2021 Article in press: December 21, 2021 Published online: January 21, 2022 Processing time: 236 Days and 14.6 Hours
Abstract
BACKGROUND
Pregnancy with renal colic may cause pyelonephritis, decreased renal function, systemic infection and even shock in pregnant women, and cause premature birth and other adverse pregnancy outcomes. When surgery is necessary, the relationship between timing of the operation and the outcome of the mother and child are not known.
AIM
To investigate the association between time to ureteral stent placement and clinical outcomes of patients with renal colic during pregnancy.
METHODS
In this retrospective study, pregnant women with renal colic who underwent surgery were studied. Maternal preoperative acute pyelonephritis (PANP), pregnancy outcome, and length of hospital stay (LOS) were compared between the two groups.
RESULTS
100 patients were included in the analysis, median age was 30 years. Median time to ureteral stent placement was 48 h (interquartile range, 25-96 h), and 32 patients (32%) were diagnosed with PANP. PANP was closely related to hospitalization costs, re-admission to the hospital due to urinary tract infection after surgery and premature delivery. Multivariate analysis found that stone location and time from pain to admission were related to PANP.
CONCLUSION
Both early and delayed surgery are safe and effective for the treatment of renal colic during pregnancy. Early surgery may be superior to a delayed procedure due to shorter LOS. For pregnant patients with renal colic, delayed surgery within 48 h is not related to the clinical outcome of the mother and child. However, the time from pain to hospital admission was related to PANP.
Core Tip: Acute renal colic is one of the most common reasons for pregnant women to be hospitalized for non-obstetric reasons. Renal colic in most patients is resolved after conservative treatment. However, when conservative treatment fails, active surgical treatment is necessary, thus the choice of the timing of the operation is very important. In this study, we examined the relationship between the timing of the operation and the outcome of the mother and child.
