Learn about Ureteral Stenting and Pregnancy

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What is Ureteral Stenting?

Kidney stones, blood clots, or infection can obstruct the ureters and prevent urine from flowing properly. Long, narrow tubes that transfer urine from the kidneys to the urinary bladder are known as the ureters. If the blockage occurs, restoration of the urinary flow is necessary by placing a ureteral stent in the ureter. A ureteral stent is a small plastic tube inserted through the urethra or urine channel, into the urinary bladder, and positioned in the ureter to increase the ability of urinary drainage from the kidneys. It remains there from weeks to months until the ureter has healed completely.

Why is a Ureteral Stent Performed?

Urinary track might change during pregnancy including the presence of renal stone. Renal stones are an amalgamation of calcium salts along with phosphate and oxalate. Stones can be present in both kidneys, but a pregnant woman commonly can have renal stones in the ureter leading to either ureteral blockage or infection.

This condition will result in hydronephrosis in which the kidney is dilated with urine as a stone obstructs the urinary flow, making urine back in the small tubes of the kidneys and renal pelvis. It will enlarge the kidneys and elevate the pressure on them, leading to loss of renal function. If you are conceiving, hydronephrosis might occur as early as the sixth week of pregnancy resulting in unbearable pain.

Since the enlarging uterus presses the ureters, it will make hydronephrosis possible during pregnancy. In addition, hormonal changes might decrease the muscular contractions that allow urine to flow through the ureters, exacerbating this condition.

Symptoms include high fever above 100 degrees Fahrenheit, inability to urinate, and bloody urine after three days. You can restore normal kidney function by undergoing the stenting procedure, which necessitates a spinal or general anesthetic. With that said, ureteral stenting and pregnancy are closely interrelated for pregnant women with kidney stone problems.

Who Performs the Procedure?

A urologist or an interventional radiologist performs this procedure. A urologist is a professional physician who focuses on diagnosing and treating diseases of genital organs and urinary tract. An interventional radiologist is a trained physician who specializes in utilizing imaging techniques to diagnose and treat medical disorders.

How to Diagnose Ureteral Obstruction

Modern technologies can diagnose the obstruction in the ureter in a variety of ways including:

• Ultrasonography, which is an imaging method that applies high-frequency sound waves to produce accurate images of structures inside human body

• Cystoscopy, which is a telescopic inspection that looks at the interior lining of the bladder and the urethra by inserting a tubular instrument

You must abstain from food or drink for eight hours before undergoing this procedure.

Risks and Complications

The possible complications that might occur after the stenting procedure include:

• Hemorrhage that requires blood transfusion

• Worsening infection

• Penetration of the adjoining organs like lungs, bowel, or gallbladder

• Flank pain while urinating and frequent urination caused by coiling of the ureteral stent in the ureter

• Spasm of the bladder after the stent is positioned in the ureter

However, these complications result in momentary effects and disappear with the removal of the stent.

Follow-up Care

Once you have a ureteral stent placed, you can return to your normal routine but you need to avoid doing exhausting activities for a week after stent placement. You are encouraged to drink at least 6 to 8 glasses of water per day, but try to limit water consumption after dinner to prevent excessive urination at night. Recovery time may vary. Your physician will consider removing the ureteral stent every six months.

References

Encyclopedia of Surgery: Ureteral Stenting - https://www.surgeryencyclopedia.com/St-Wr/Ureteral-Stenting.html

UW Health: Ureteral Stent Placement / Removal - https://www.uwhealth.org/healthfacts/B_EXTRANET_HEALTH_INFORMATION-FlexMember-Show_Public_HFFY_1126655500386.html

The Female Patient: Kidney Stones and Pregnancy - https://www.femalepatient.com/html/arc/sig/uroG/articles/035_02_015.asp

The Merck Manuals: Hydronephrosis - https://www.merck.com/mmhe/sec11/ch148/ch148b.html

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