Introduction
Flank pain is a clinical condition occurring as well as in pregnancy and
causes frequent emergency room (ER) visits. Most of the pregnant women
presenting with flank pain might have
hydronephrosis.(1) During the course of pregnancy mild
hydronephrosis is reported in 90% of the patients. It is more
frequently experienced by the nulliparous (1-3). In
pregnancies, hydronephrosis mostly develops in the right kidney and
might cause pyelonephritis and urosepsis (4). More
frequent occurrence on the right side is ascribed to dextrorotation of
the uterus and protection of the left ureter by the sigmoid
colon.(5) It has been asserted that in the mechanism
of hydronephrosis formation, in addition to uterine compression, is
progesterone hormone’s relaxing effect on the smooth
muscle.(6, 7) In many studies, such issues as urinary
stone disease causing urinary obstruction and urinary tract infection
secondary to ureteric obstruction have been
addressed.(4) Although hydronephrosis may be seen in
90% of pregnancies, in most of the cases they are observed without any
symptoms.(5, 8) Some of these patients may present
with severe flank pain, recurrent urinary tract infections and even
renal dysfunction.(5) Most of the patients benefit
from conservative approach and medical treatment. However, invasive
procedures such as ureteral stent or renal nephrostomy may be needed in
6%. (5, 9)
In this study, factors other than pregnancy such as ureteral stones and
urinary tract infection that might cause hydronephrosis and pain were
excluded. We aimed to investigate the relationship between nulliparity
and multiparity with hydronephrosis and pain, as well as the
relationship between the degree of hydronephrosis and pain.