Review Maternal urological problems in pregnancy Paul Fiadjoe a,b, *, Kurinji Kannan a,b , Ajay Rane a,b a Department of Urogynaecology, The Townsville Hospital, Angus Smith Drive Douglas, Townsville, QLD 4814, Australia b School of Medicine, James Cook University, Angus Smith Drive, Townsville, QLD 4810, Australia Contents 1. Introduction ...................................................................................................... 13 1.1. Anatomical and physiological changes ........................................................................... 14 2. Upper urinary tract ................................................................................................ 14 2.1. Hydronephrosis .............................................................................................. 14 2.2. Urinary tract infection (UTI) .................................................................................... 14 2.3. Calculus disease causing pain .................................................................................. 14 2.4. Renal failure ................................................................................................ 15 2.5. Renal tumour ............................................................................................... 15 3. Lower tract ....................................................................................................... 15 3.1. Lower urinary tract symptoms: filling and voiding.................................................................. 15 3.2. Urinary incontinence ......................................................................................... 15 3.3. Cystitis..................................................................................................... 16 3.4. Bladder cancer .............................................................................................. 16 3.5. Trauma during delivery ....................................................................................... 16 4. Conclusion ....................................................................................................... 16 References ....................................................................................................... 16 1. Introduction The many anatomical and physiological changes occurring during pregnancy affect the entire urinary tract. Accentuation of these changes can become pathological, alter renal function and induce various urological diseases which can be life-threatening to fetus and/or mother. Some changes can persist postpartum. Physiological hydronephrosis is the most significant renal alter- ation during pregnancy, occurring in about 90% of pregnant women by the third trimester. Frequency and urgency of micturition are common in pregnancy and are mostly due to increased urine output but may be associated with urinary tract infection requiring treatment in 4% of pregnancies. Urgency occurs in 60% of pregnancies, with 5.9% of women developing urge urinary incontinence in the third trimester [1]. Urodynamic studies have shown that 8% of pregnant European Journal of Obstetrics & Gynecology and Reproductive Biology 152 (2010) 13–17 ARTICLE INFO Article history: Received 25 March 2009 Received in revised form 5 April 2010 Accepted 26 April 2010 Keywords: Asymptomatic bacteriuria Pyelonephritis Calculi Urinary incontinence Fistulae ABSTRACT Urological conditions in pregnancy represent a major diagnostic and therapeutic challenge. During pregnancy the urinary tract undergoes some anatomical and physiological changes that may result in many symptoms and pathological conditions affecting both the mother and fetus. With prompt evaluation and expeditious treatment, the prognosis is good. Fear of causing harm is unfounded. This article describes urological problems in pregnancy, specifically infection, calculus, renal failure, renal tumour, lower urinary tract symptoms and trauma and their management. Crown Copyright ß 2010 Published by Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: Department of Urogynaecology, The Townsville Hospital, Angus Smith Drive Douglas, Townsville, QLD 4814, Australia. Tel.: +61 7 479 637 13; fax: +61 7 472 740 99. E-mail address: paul.fiadjoe@gmail.com (P. Fiadjoe). Contents lists available at ScienceDirect European Journal of Obstetrics & Gynecology and Reproductive Biology journal homepage: www.elsevier.com/locate/ejogrb 0301-2115/$ – see front matter . Crown Copyright ß 2010 Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ejogrb.2010.04.013