Double J Stents: Managing Hydronephrosis During Pregnancy

Placement of double J stent?

Hello Doctor, I am currently 34 weeks pregnant.
I have been experiencing back pain, and an ultrasound revealed hydronephrosis in both kidneys.
I just had a double J stent placed last week, and there were no stones found, only narrowing.
However, after a week, I am still experiencing back pain.
I returned for a follow-up ultrasound, and the kidneys still show hydronephrosis, although it is not as severe as before.
I would like to know if this is normal.
Will the hydronephrosis gradually resolve? What should I pay attention to? Thank you, Doctor.

Ting, 20~29 year old female. Ask Date: 2020/12/07

Dr. Cai Zhuorong reply Urology

After a week, I still feel soreness in my back and went for a follow-up ultrasound, which showed that my kidney still has hydronephrosis, although it's not as severe as before.
Is this normal? A: A double-J stent can occasionally cause discomfort.
If the ultrasound still shows hydronephrosis, it may be necessary to consider further monitoring and treatment.
Will the hydronephrosis gradually resolve? A: Hydronephrosis refers to the urine produced by the affected kidney.
Normally, one kidney is responsible for producing half of the urine volume, and most of it is drained into the bladder through the double-J stent.
What should I be aware of? A: If there is a urinary tract infection during pregnancy, treatment should be administered.
After delivery, it is essential to follow up and receive appropriate treatment.

Reply Date: 2020/12/07

More Info

Managing hydronephrosis during pregnancy, especially with the presence of Double J stents, can be a complex situation that requires careful monitoring and management. Hydronephrosis, which is the swelling of a kidney due to a build-up of urine, can occur during pregnancy due to several factors, including hormonal changes, the growing uterus, and anatomical changes that may compress the ureters.
In your case, it is not uncommon for pregnant women to experience hydronephrosis, particularly in the third trimester. The presence of the Double J stents is a common intervention to alleviate obstruction and allow urine to flow from the kidneys to the bladder. While you mentioned that you are experiencing some back pain and that your ultrasound still shows hydronephrosis, it is important to understand that some degree of hydronephrosis can persist even after the placement of stents, especially if there is ongoing compression from the uterus.

Here are some important points to consider regarding your situation:
1. Normalcy of Symptoms: It is relatively common for pregnant women to experience back pain due to various factors, including the weight of the growing fetus and changes in posture. However, persistent or severe pain should be evaluated by your healthcare provider to rule out any complications.

2. Monitoring Hydronephrosis: Regular ultrasound examinations are essential to monitor the status of your kidneys and the effectiveness of the Double J stents. Your healthcare provider will assess the degree of hydronephrosis and determine if further interventions are necessary.

3. Urine Flow and Stent Function: The Double J stents are designed to facilitate urine flow. If you are still experiencing hydronephrosis, it may indicate that the stents are not functioning optimally or that there is still some degree of obstruction. Your doctor may consider imaging studies to evaluate the stents and the urinary tract.

4. Hydration and Diet: Staying well-hydrated is crucial during pregnancy, especially when dealing with hydronephrosis. Adequate fluid intake can help promote urine flow and may alleviate some of the pressure on your kidneys.

5. Signs of Complications: Be vigilant for signs of complications, such as fever, chills, severe abdominal pain, or changes in urine output. These symptoms could indicate a urinary tract infection or other issues that require immediate medical attention.

6. Consultation with Specialists: Given the complexity of your situation, it may be beneficial to consult with both your obstetrician and a urologist. They can work together to ensure that both your pregnancy and kidney health are managed effectively.

7. Postpartum Considerations: After delivery, the pressure on your urinary tract will decrease, and many women find that their hydronephrosis resolves on its own. However, follow-up care is essential to ensure that any underlying issues are addressed.

In terms of resources, consider reaching out to reputable medical websites or organizations that focus on maternal-fetal medicine or urology. Websites such as the American Urological Association (AUA) or the Society for Maternal-Fetal Medicine (SMFM) can provide valuable information on managing hydronephrosis during pregnancy.

In summary, while some degree of hydronephrosis may persist during pregnancy, it is crucial to maintain open communication with your healthcare team, monitor your symptoms, and follow their recommendations closely. Your health and the health of your baby are the top priorities, and with proper management, many women navigate this situation successfully.

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