Factors affecting the need for ureteral catheterization in symptomatic pregnancy hydronephrosis.

PURPOSE: In our study, considering the clinical parameters we aimed to determine the most appropriate treatment approach for symptomatic gestational hydronephrosis and conditions requiring DJS insertion.

METHODS: Our study was a retrospective cross-sectional study and 137 patients were included. The patients were divided into two groups: those with conservative follow-up and those with DJS. Demographic and clinical data, the degree of HUN detected in urinary ultrasonography and the anteroposterior diameter of the renal pelvis were evaluated. Factors affecting the need for DJS between groups were investigated. Also, it was aimed to determine the cut-off value for the HUN degree and renal pelvis AP diameter in patients with DJS.

RESULTS: The presence of urinary system stones was statistically significantly higher in the group with DJS than in the group without DJS (p = 0.014). HUN degrees and AP diameter were statistically significantly higher in the DJS group (p < 0.001, p < 0.001, respectively). HUN degree and renal pelvis AP diameter were the two most important predictors for DJS insertion (p = 0.005, p = 0.015, respectively). The AP diameter cut-off value for DJS installation was determined as 20.5 mm.

CONCLUSION: Although there are conservative and surgical treatment options for symptomatic hydronephrosis of pregnancy, the factors at the decision point between these options are still a matter of debate. In our study, we concluded that the most important determinants at this decision point are the HUN degree and renal pelvis AP diameter. We think that the cut-off values we have determined for these markers will guide clinicians in deciding on treatment.