Ureteroscopy for treatment of obstructing ureteral calculi in pregnant women: Single center experience
Objectives: To evaluate our experiences with ureteroscopic treatment of ureteral calculi in pregnancy. Patients and methods: Between April 2006 and October 2013, 41 pregnant women with persistent renal colics and/or hematuria refractory to conservative measures were treated with ureteroscopy. The pa...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2016-06-01
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| Series: | African Journal of Urology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1110570415000557 |
| _version_ | 1817978994631376896 |
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| author | T.K. Fathelbab A.M.A. Hamid E.M. Galal |
| author_facet | T.K. Fathelbab A.M.A. Hamid E.M. Galal |
| author_sort | T.K. Fathelbab |
| collection | DOAJ |
| description | Objectives: To evaluate our experiences with ureteroscopic treatment of ureteral calculi in pregnancy.
Patients and methods: Between April 2006 and October 2013, 41 pregnant women with persistent renal colics and/or hematuria refractory to conservative measures were treated with ureteroscopy. The patients’ mean age was 23 (range 19–37) years. Most of the patients (56.1%) presented in the 2nd trimester.
Loin pain and colic were the most common presenting symptoms (90.2%). Twenty-seven patients (65.9%) had an obstruction on the right side. All patients underwent ureteroscopy under epidural anesthesia.
Results: Ureteroscopy revealed the presence of ureteric stones in 36 of the 41 cases. The stone size ranged from 5 to 16 (mean 8.9) mm. Distal ureteric stones were found in 29 patients. The pneumatic lithoclast was used for stone fragmentation in 22 of them (75.9%), while the stone was directly extracted in 4 patients. In 3 patients the stone migrated proximally and was not accessible any more. Proximal ureteric stones were detected in 7 of the remaining 12 cases. When attempting to manipulate these stones, they migrated more proximally and became unreachable. In the last 5 patients the entire ureter was free of stones; they only had edema at the ureteric orifice. A long lasting JJ stent was left until the end of the pregnancy in all cases with migrated inaccessible stones. In all patients successfully treated, a JJ stent with dangle extraction strings was left for two weeks. Minor urologic complications were encountered in the form of mild dysuria in 12 cases (29.2%) and mild hematuria in 5 cases (12.2%). All patients completed their pregnancy until full term without any serious obstetric complications requiring intervention.
Conclusion: Ureteroscopy is a safe and effective therapeutic option for the treatment of obstructing ureteral stones in pregnancy with stone-free and complication rates comparable to the non-pregnant population. |
| first_indexed | 2024-04-13T22:37:10Z |
| format | Article |
| id | doaj.art-5e7343617fec4123bfa8e447b9a317d9 |
| institution | Directory Open Access Journal |
| issn | 1110-5704 |
| language | English |
| last_indexed | 2024-04-13T22:37:10Z |
| publishDate | 2016-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | African Journal of Urology |
| spelling | doaj.art-5e7343617fec4123bfa8e447b9a317d92022-12-22T02:26:44ZengSpringerOpenAfrican Journal of Urology1110-57042016-06-0122210610910.1016/j.afju.2014.12.005Ureteroscopy for treatment of obstructing ureteral calculi in pregnant women: Single center experienceT.K. FathelbabA.M.A. HamidE.M. GalalObjectives: To evaluate our experiences with ureteroscopic treatment of ureteral calculi in pregnancy. Patients and methods: Between April 2006 and October 2013, 41 pregnant women with persistent renal colics and/or hematuria refractory to conservative measures were treated with ureteroscopy. The patients’ mean age was 23 (range 19–37) years. Most of the patients (56.1%) presented in the 2nd trimester. Loin pain and colic were the most common presenting symptoms (90.2%). Twenty-seven patients (65.9%) had an obstruction on the right side. All patients underwent ureteroscopy under epidural anesthesia. Results: Ureteroscopy revealed the presence of ureteric stones in 36 of the 41 cases. The stone size ranged from 5 to 16 (mean 8.9) mm. Distal ureteric stones were found in 29 patients. The pneumatic lithoclast was used for stone fragmentation in 22 of them (75.9%), while the stone was directly extracted in 4 patients. In 3 patients the stone migrated proximally and was not accessible any more. Proximal ureteric stones were detected in 7 of the remaining 12 cases. When attempting to manipulate these stones, they migrated more proximally and became unreachable. In the last 5 patients the entire ureter was free of stones; they only had edema at the ureteric orifice. A long lasting JJ stent was left until the end of the pregnancy in all cases with migrated inaccessible stones. In all patients successfully treated, a JJ stent with dangle extraction strings was left for two weeks. Minor urologic complications were encountered in the form of mild dysuria in 12 cases (29.2%) and mild hematuria in 5 cases (12.2%). All patients completed their pregnancy until full term without any serious obstetric complications requiring intervention. Conclusion: Ureteroscopy is a safe and effective therapeutic option for the treatment of obstructing ureteral stones in pregnancy with stone-free and complication rates comparable to the non-pregnant population.http://www.sciencedirect.com/science/article/pii/S1110570415000557StonesUreteroscopyPregnancy |
| spellingShingle | T.K. Fathelbab A.M.A. Hamid E.M. Galal Ureteroscopy for treatment of obstructing ureteral calculi in pregnant women: Single center experience African Journal of Urology Stones Ureteroscopy Pregnancy |
| title | Ureteroscopy for treatment of obstructing ureteral calculi in pregnant women: Single center experience |
| title_full | Ureteroscopy for treatment of obstructing ureteral calculi in pregnant women: Single center experience |
| title_fullStr | Ureteroscopy for treatment of obstructing ureteral calculi in pregnant women: Single center experience |
| title_full_unstemmed | Ureteroscopy for treatment of obstructing ureteral calculi in pregnant women: Single center experience |
| title_short | Ureteroscopy for treatment of obstructing ureteral calculi in pregnant women: Single center experience |
| title_sort | ureteroscopy for treatment of obstructing ureteral calculi in pregnant women single center experience |
| topic | Stones Ureteroscopy Pregnancy |
| url | http://www.sciencedirect.com/science/article/pii/S1110570415000557 |
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