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Tamura D, Narita S, Yamauchi M, Watanabe R, Yokoyama S, Kikuchi A, Shitara A, Chiba S, Saito F, Sugita A, Sato K, Karube A. Perinatal Management in a Pregnant Woman with Ureteropelvic Junction Obstruction: Case Report and Literature Review. Diagnostics (Basel) 2022; 12:diagnostics12040913. [PMID: 35453962 PMCID: PMC9029582 DOI: 10.3390/diagnostics12040913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/02/2022] [Accepted: 04/03/2022] [Indexed: 12/10/2022] Open
Abstract
Although giant hydronephrosis (GH) associated with ureteropelvic junction obstruction (UPJO) is extremely rarely detected in pregnant women, diagnostic methods, therapeutic approaches, and perinatal management have not been established. A 31-year-old Japanese primipara had a 15 cm × 12 cm multi-cystic mass in the right abdomen detected by transabdominal ultrasound at gestational week 26. Magnetic resonance imaging revealed that the mass was right renal GH. She underwent serial ultrasound-guided transretroperitoneal drainage as conservative treatment. She delivered vaginally at gestational week 36. Since she had flank pain and a documented non-functional right kidney, laparoscopic nephrectomy was conducted 22 months after delivery. UPJO with fewer smooth muscle cells and fibrosis was histologically diagnosed in the surgical specimen. Her postpartum and postoperative courses were uneventful for 10 months. We performed a literature review of diagnostic methods, clinical characteristics, and perinatal management in pregnant women with GH due to UPJO.
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Affiliation(s)
- Daisuke Tamura
- Department of Obstetrics and Gynecology, Yuri-Kumiai General Hospital, Akita 015-8511, Japan; (R.W.); (S.Y.); (A.S.); (F.S.); (A.K.)
- Correspondence:
| | - Shintaro Narita
- Department of Urology, Akita University School of Medicine, Akita 010-8543, Japan;
| | - Misa Yamauchi
- Department of Pathology, Yuri-Kumiai General Hospital, Akita 015-8511, Japan; (M.Y.); (A.S.)
| | - Rina Watanabe
- Department of Obstetrics and Gynecology, Yuri-Kumiai General Hospital, Akita 015-8511, Japan; (R.W.); (S.Y.); (A.S.); (F.S.); (A.K.)
| | - Shota Yokoyama
- Department of Obstetrics and Gynecology, Yuri-Kumiai General Hospital, Akita 015-8511, Japan; (R.W.); (S.Y.); (A.S.); (F.S.); (A.K.)
| | - Akane Kikuchi
- Department of Urology, Yuri-Kumiai General Hospital, Akita 015-8511, Japan; (A.K.); (S.C.); (K.S.)
| | - Akihiro Shitara
- Department of Obstetrics and Gynecology, Yuri-Kumiai General Hospital, Akita 015-8511, Japan; (R.W.); (S.Y.); (A.S.); (F.S.); (A.K.)
| | - Syuji Chiba
- Department of Urology, Yuri-Kumiai General Hospital, Akita 015-8511, Japan; (A.K.); (S.C.); (K.S.)
| | - Fumiko Saito
- Department of Obstetrics and Gynecology, Yuri-Kumiai General Hospital, Akita 015-8511, Japan; (R.W.); (S.Y.); (A.S.); (F.S.); (A.K.)
| | - Akihiro Sugita
- Department of Pathology, Yuri-Kumiai General Hospital, Akita 015-8511, Japan; (M.Y.); (A.S.)
| | - Kazunari Sato
- Department of Urology, Yuri-Kumiai General Hospital, Akita 015-8511, Japan; (A.K.); (S.C.); (K.S.)
| | - Akihiro Karube
- Department of Obstetrics and Gynecology, Yuri-Kumiai General Hospital, Akita 015-8511, Japan; (R.W.); (S.Y.); (A.S.); (F.S.); (A.K.)
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