Experience with the diagnosis and management of symptomatic ureteric stones during pregnancy

Abstract

Objective: To present our experience to describe diagnosis and management of symptomatic ureteric stones during pregnancy.

Materials and methods: Thirty-six pregnant women with symptomatic ureteric stones were evaluated in this study. The diagnosis was done by history, physical examination, symptoms, signs, ultrasonography, or ureteroscopy if needed. Initially, conservative management was performed on all patients. When conservative treatment failed, temporizing therapies (double-J stenting or percutaneous nephrostomy [PCN]) and (ureteroscopic lithotripsy) URSL were performed on the patients.

Results: In 25 (69.4%) of the patients, ureteric stones was diagnosed on US. In the other 11 (30.6%) of the patients, definitive diagnosis was done by ureteroscopy in 5, and 6 of them passed their stones spontaneously. Conservative management was successful in 24 of 36 (66.6%) the patients. Temporizing therapies and URSL were required in 12 of 36 (33.4%) patients. A double-J stent was successfully placed in only 3 (8.3%) of the patients, and URSL was performed in 9 (25%). In 1 (2.7%) patient, PCN was performed because of persistent renal colic, fever, and pyonephrosis. In this patient, URSL was performed after symptoms and signs resolved, and then the percutaneous tube was removed.

Conclusion: If ultrasonography fails, ureteroscopy may be an alternative approach for definitive diagnosis. When conservative approach fails, URSL may be a good alternative approach for definitive treatment.