Rigid ureteroscopy in pregnant women

Abstract

Objective: To report our experience with rigid ureteroscopy in pregnant women.

Patients and methods: Ten pregnant women (mean age 25 years, SD 4.5, range 22-33) with ureteric stones were treated by ureteroscopy. The mean (SD, range) gestation time was 24 (6.5, 19-33) weeks. A standard rigid ureteroscope of 11.5 F was used in eight patients and 9.5 F in two. The procedure was carried out with no ureteric dilatation in three patients and with easy dilatation in seven. Fluoroscopy was not used before or during ureteroscopy in any case. Ultrasonography was available throughout the procedures for constant renal and obstetric monitoring.

Results: Mid and lower ureteric stones were extracted by basket or forceps in three patients and had to be disintegrated by ultrasound in two. Upper ureteric stones were displaced to the kidney, with placement of double-pigtail ureteric stents, in three patients who were subsequently treated after delivery. Ureteric oedema was seen in one patient and the endoscopic findings were normal in the remaining patient. There were no obstetric complications. Two patients had a urinary tract infection and one complained of stent-induced bladder irritation.

Conclusions: Rigid ureteroscopy is a safe and reliable method in the diagnosis and treatment of ureteric calculi during pregnancy. The procedure can be performed with ultrasonographic monitoring and without using fluoroscopy.