The evaluation of ureteroscopy and pneumatic lithotripsy results in pregnant women with urethral calculi

Abstract

Background: Urinary stone incidence in pregnancy has been reported in a wide range, from 1 in 200 to 1 in 2000 cases.

Objectives: The aim of this study was to investigate the efficacy and safety of ureteroscopic treatment and its results and complications for pregnant women with urinary stones.

Patients and methods: From 2003 till 2011, 113 pregnant patients with symptomatic urolithiasis were admitted to the urology emergency clinic at Imam Reza hospital. All patients were initially treated conservatively, resulting in spontaneous passage of the calculi in 69 patients. Forty-four patients with symptomatic urolithiasis were included in the study. Post-operative follow ups, including maternal and fetal health was performed by a gynecologist consult fetal heart rate assessment and urine analysis and culture and renal and urethral ultrasonography.

Results: The mean age of the patients was 23 years ± 2 (19-34) and the mean gestational age was 24 ± 3 weeks. The overall and pneumatic lithotripsy success rate was 100%. All patients from the interventional group delivered at term with no fetal or maternal complications. There was no morbidity during and after the operation.

Conclusions: In conditions, medical management of urinary stones and consequent renal colic in pregnant women cannot improve patients' symptoms, choosing of a surgical method like setting of a DJ catheter or URS and pneumatic lithotripsy can be a safe and effective way for the health of both the mother and fetus. Of course, more research is needed to establish this approach as the standard method in pregnancy urinary stones.

Keywords: Lithotripsy; Urinary Calculi; Urolithiasis.