Outcomes of ureteroscopy and internal ureteral stent for pregnancy with urolithiasis: a systematic review and meta-analysis

Abstract Objectives To investigate the outcomes of internal ureteral stents in comparison with ureteroscopy (URS) for pregnant women with urolithiasis. Data sources Relevant studies published from January 1980 to June 2022 were identified through systematic literature searches of MEDLINE, EMBASE, We...

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Main Authors: Xingwei Jin, Boke Liu, Yunqi Xiong, Yuanchun Wang, Weichao Tu, Yuan Shao, Lin Zhang, Dawei Wang
Format: Article
Language:English
Published: BMC 2022-09-01
Series:BMC Urology
Subjects:
Online Access:https://doi.org/10.1186/s12894-022-01100-w
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author Xingwei Jin
Boke Liu
Yunqi Xiong
Yuanchun Wang
Weichao Tu
Yuan Shao
Lin Zhang
Dawei Wang
author_facet Xingwei Jin
Boke Liu
Yunqi Xiong
Yuanchun Wang
Weichao Tu
Yuan Shao
Lin Zhang
Dawei Wang
author_sort Xingwei Jin
collection DOAJ
description Abstract Objectives To investigate the outcomes of internal ureteral stents in comparison with ureteroscopy (URS) for pregnant women with urolithiasis. Data sources Relevant studies published from January 1980 to June 2022 were identified through systematic literature searches of MEDLINE, EMBASE, Web of Science and the Cochrane Library. Methods of study selection A total of 499 studies were initially identified. We included pregnant women in any stages of gestation who underwent double-J (D-J) stent insertion only or ureteroscopy for the treatment of urolithiasis; for a study to be included, the number of participants needed to exceed 10. This systematic review was registered on the PROSPERO website (Reference: CRD42020195607). Results A total of 25 studies were identified with 131 cases undergoing serial stenting and 789 cases undergoing URS. The pooled operative success rate was 97% for D-J stent insertion and 99% for URS. Only a few patients passed stones spontaneously after serial D-J stenting. The pooled stone free rate (SFR) in URS operations was about 91%. For internal ureteral stent therapy, the rate of normal fertility outcomes was 99%, although the pooled incidence of complications was approximately 45%. For group receiving URS treatment, the rate of normal fertility outcome was 99% and the pooled incidence of complications was approximately 1%. However, the pooled rate of premature birth and abortion were the similar between the two groups (< 1%); the rate of serious complications was also similar between the two groups. Conclusions Although internal ureteral stents may cause more minor complications, both ureteroscopy and internal ureteral stents showed had low rates of adverse effects on fertility outcomes when used to treat pregnant women with symptomatic urolithiasis. Evidence suggests that URS may have a greater advantage for pregnant patients with urinary stones when conditions permit. Since, it has been proven to be safe and effective, internal ureteral stents could be considered in emergency or other special situations.
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spelling doaj.art-4a5a5166200d46aa918d50f0a63ed2772022-12-22T04:30:42ZengBMCBMC Urology1471-24902022-09-0122112110.1186/s12894-022-01100-wOutcomes of ureteroscopy and internal ureteral stent for pregnancy with urolithiasis: a systematic review and meta-analysisXingwei Jin0Boke Liu1Yunqi Xiong2Yuanchun Wang3Weichao Tu4Yuan Shao5Lin Zhang6Dawei Wang7Department of Urology, School of Medicine, Ruijin Hospital, Shanghai Jiaotong UniversityDepartment of Urology, School of Medicine, Ruijin Hospital, Shanghai Jiaotong UniversityDepartment of Gynaecology and Obstetrics, Shanghai TCM College Affiliated Shu Guang HospitalMonash Health, Monash Medical CentreDepartment of Urology, School of Medicine, Ruijin Hospital, Shanghai Jiaotong UniversityDepartment of Urology, School of Medicine, Ruijin Hospital, Shanghai Jiaotong UniversitySchool of Population Medicine and Public Health, Chinese Academy of Medical Science & Peking Union Medical CollegeDepartment of Urology, School of Medicine, Ruijin Hospital, Shanghai Jiaotong UniversityAbstract Objectives To investigate the outcomes of internal ureteral stents in comparison with ureteroscopy (URS) for pregnant women with urolithiasis. Data sources Relevant studies published from January 1980 to June 2022 were identified through systematic literature searches of MEDLINE, EMBASE, Web of Science and the Cochrane Library. Methods of study selection A total of 499 studies were initially identified. We included pregnant women in any stages of gestation who underwent double-J (D-J) stent insertion only or ureteroscopy for the treatment of urolithiasis; for a study to be included, the number of participants needed to exceed 10. This systematic review was registered on the PROSPERO website (Reference: CRD42020195607). Results A total of 25 studies were identified with 131 cases undergoing serial stenting and 789 cases undergoing URS. The pooled operative success rate was 97% for D-J stent insertion and 99% for URS. Only a few patients passed stones spontaneously after serial D-J stenting. The pooled stone free rate (SFR) in URS operations was about 91%. For internal ureteral stent therapy, the rate of normal fertility outcomes was 99%, although the pooled incidence of complications was approximately 45%. For group receiving URS treatment, the rate of normal fertility outcome was 99% and the pooled incidence of complications was approximately 1%. However, the pooled rate of premature birth and abortion were the similar between the two groups (< 1%); the rate of serious complications was also similar between the two groups. Conclusions Although internal ureteral stents may cause more minor complications, both ureteroscopy and internal ureteral stents showed had low rates of adverse effects on fertility outcomes when used to treat pregnant women with symptomatic urolithiasis. Evidence suggests that URS may have a greater advantage for pregnant patients with urinary stones when conditions permit. Since, it has been proven to be safe and effective, internal ureteral stents could be considered in emergency or other special situations.https://doi.org/10.1186/s12894-022-01100-wPregnancyUrolithiasisDouble-J stentUreteroscopy
spellingShingle Xingwei Jin
Boke Liu
Yunqi Xiong
Yuanchun Wang
Weichao Tu
Yuan Shao
Lin Zhang
Dawei Wang
Outcomes of ureteroscopy and internal ureteral stent for pregnancy with urolithiasis: a systematic review and meta-analysis
BMC Urology
Pregnancy
Urolithiasis
Double-J stent
Ureteroscopy
title Outcomes of ureteroscopy and internal ureteral stent for pregnancy with urolithiasis: a systematic review and meta-analysis
title_full Outcomes of ureteroscopy and internal ureteral stent for pregnancy with urolithiasis: a systematic review and meta-analysis
title_fullStr Outcomes of ureteroscopy and internal ureteral stent for pregnancy with urolithiasis: a systematic review and meta-analysis
title_full_unstemmed Outcomes of ureteroscopy and internal ureteral stent for pregnancy with urolithiasis: a systematic review and meta-analysis
title_short Outcomes of ureteroscopy and internal ureteral stent for pregnancy with urolithiasis: a systematic review and meta-analysis
title_sort outcomes of ureteroscopy and internal ureteral stent for pregnancy with urolithiasis a systematic review and meta analysis
topic Pregnancy
Urolithiasis
Double-J stent
Ureteroscopy
url https://doi.org/10.1186/s12894-022-01100-w
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