Ureteroscopic treatment of ureteral lithiasis in pregnancy
Article published in Urologia Polska 2006/59/2.

authors

Ewa Bres-Niewada, Janusz Judycki, Andrzej Borkowski, Maciej Czaplicki

Katedra i Klinika Urologii Akademii Medycznej w Warszawie

keywords

pregnancy, renal colic, lithiasis, ureteroscopy, lithotripsy

summary

Objectives. Our experiences with ureteroscopic treatment (URS) of ureteral lithiasis in pregnancy are reported.

Materials and methods. From 01.1999 to 09.2005 eleven pregnant women with symptoms of ureteral obstruction were treated by ureteroscopy. Transabdominal ultrasound showed ureteral lithiasis in 10 patients, in one individual with hydronephrosis the stone was not found. Twelve URS procedures were performed (one woman underwent ureteroscopy twice during the same pregnancy) - eleven to extract obstructing ureteral calculi, one in order to place a double J stent under visual control (after failure of the cystoscopic approach).

Results. A standard rigid ureteroscope 7.5 F was used. In one patient it was necessary to use a flexible ureteroscope. In all patients ureteroscopy could be performed without substantial technical difficulties. The stones were extracted by forceps or basket. The balistic lithotripsy or holmium laser lithotripsy were used when disintegration of a stone was needed. Nine patients were rendered free of stone. In two women the stone was pushed into the renal pelvis up. The ureteral stent was placed temporarily or for the rest of the pregnancy in most patients. No urologic or obstetric complications were observed.

Conclusions. Ureteroscopy seems to be safe and effective procedure that may be used to diagnose and extract obstructing ureteral calculi during pregnancy with a low and acceptable risk to the mother and foetus. Ureteroscopy can be performed as a first-line surgical intervention when conservative measures fail.

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