Aim : We aimed to investigate the correlation of acute flank
pain incidence with number of pregnancies and hydronephrosis.
Material and method : Forty-eight patients admitted with acute
flank pain have been included in this study. Patients with urinary tract
infection, abnormal urinalysis, kidney or ureteric stone have been
excluded. Twenty-four were nulliparous and the remaining pregnancies
were multiparous. All patients had urinary ultrasound (US) by the same
radiologist. Visual analogue scale (VAS) was used. All the patients had
conservative management firstly. same radiologist. Visual analogue scale
(VAS) was used when patients admitted to the hospital. All the patients
had intravenous fluid therapy as conservative management, paracetamol as
analgesic treatment and oral nitrofurantoin as antibiotherapy. Patients
who did not benefit from conservative treatment had ureteral JJ stent
placement.
Results : Nulliparous pregnant were younger and had earlier
gestational weeks (25.1±3.7 – 28.7±3.8 p=0.004 and 22,9±3.7 – 26.3±4.0
p=0.005), but higher VAS scores. In the nulliparous pregnant women, a
significant, medium level positive correlation was found between the
degree of hydronephrosis and the VAS scores. It was observed that the
higher the hydronephrosis, the higher the VAS scores were. On the other
hand, in multiparous pregnant women, no correlation was detected between
the degree of hydronephrosis and the VAS scores. In comparison of two
groups in relation to BM, hydronephrosis degree, hydronephrosis side,
serum creatinine levels, type and side of pain, no significant
difference was identified. Forty-two percent of patients described a
colic pain. While 91.7% of the patients benefitted from conservative
treatment, 4 patients had JJ stent insertion.
Conclusion : This study demonstrates that there is a correlation
between acute flank pain and hydronephrosis and that the degree of
hydronephrosis increases as the pain intensifies, especially in the
nulliparous, such correlation is stronger.
Keywords: Pregnancy, hydronephrosis, acute flank pain,
nulliparous, multiparous