BACKGROUND AND PURPOSE: Renal colic in pregnancy presents a diagnostic and therapeutic challenge. When conservative therapy fails or is not indicated, temporary measures such as ureteral stenting are often chosen as a first-line intervention, postponing definitive management until after delivery. We propose that advances in endoscopic equipment and anesthesia techniques dictate a more definitive strategy. PATIENTS AND METHODS: A retrospective analysis was performed on 10 consecutive pregnant patients presenting with renal colic necessitating intervention between April 1998 and April 2000. The mean patient age was 23 (range 17-31) years. One patient presented during the first trimester, six in the second, and three in the third. Four of the patients had a history of stone disease. All patients had flank pain at presentation, six on the left side and four on the right. Hematuria, fever, and nausea were present in eight, one and two patients, respectively. RESULTS: Ultrasound scanning was performed in all patients and showed a low sensitivity (28.5%) when compared with intraoperative findings. Ureteroscopy (rigid and/or flexible) was performed as a first-line intervention in six patients, in two of whom no stone was found. Percutaneous nephrolithotomy was carried out in one patient presenting with a nephrostomy tube. Double-J stents were placed in only three patients with specific indications, namely urinary infection, late gestational phase, and difficult ureteroscopy secondary to a narrow ureter. No obstetric or urologic complications were noted. The mean size of the stones retrieved in seven patients was 7 mm. CONCLUSIONS: Ureteroscopy may be considered a safe and effective first-line definitive therapeutic option in pregnant patients requiring intervention for stone disease.
BACKGROUND AND PURPOSE:Renal colic in pregnancy presents a diagnostic and therapeutic challenge. When conservative therapy fails or is not indicated, temporary measures such as ureteral stenting are often chosen as a first-line intervention, postponing definitive management until after delivery. We propose that advances in endoscopic equipment and anesthesia techniques dictate a more definitive strategy. PATIENTS AND METHODS: A retrospective analysis was performed on 10 consecutive pregnant patients presenting with renal colic necessitating intervention between April 1998 and April 2000. The mean patient age was 23 (range 17-31) years. One patient presented during the first trimester, six in the second, and three in the third. Four of the patients had a history of stone disease. All patients had flank pain at presentation, six on the left side and four on the right. Hematuria, fever, and nausea were present in eight, one and two patients, respectively. RESULTS: Ultrasound scanning was performed in all patients and showed a low sensitivity (28.5%) when compared with intraoperative findings. Ureteroscopy (rigid and/or flexible) was performed as a first-line intervention in six patients, in two of whom no stone was found. Percutaneous nephrolithotomy was carried out in one patient presenting with a nephrostomy tube. Double-J stents were placed in only three patients with specific indications, namely urinary infection, late gestational phase, and difficult ureteroscopy secondary to a narrow ureter. No obstetric or urologic complications were noted. The mean size of the stones retrieved in seven patients was 7 mm. CONCLUSIONS: Ureteroscopy may be considered a safe and effective first-line definitive therapeutic option in pregnant patients requiring intervention for stone disease.
Authors: Saween K S Thompson; Stanford M Goldman; Komal B Shah; Phebe C Chen; Louis K Wagner; Frank M Corl; Bharat K Raval; Shela Sheth; Elliot K Fishman; Carl M Sandler Journal: Emerg Radiol Date: 2005-06
Authors: Yasar Bozkurt; Necmettin Penbegul; Haluk Soylemez; Murat Atar; Ahmet Ali Sancaktutar; Kadir Yıldırım; Muhammet Erdal Sak Journal: Urol Res Date: 2012-01-04
Authors: Yasar Bozkurt; Haluk Soylemez; Murat Atar; Ahmet Ali Sancaktutar; Necmettin Penbegul; Namık Kemal Hatipoglu; Mehmet Nuri Bodakcı; Mehmet Sıddık Evsen Journal: Urolithiasis Date: 2012-12-23 Impact factor: 3.436