Literature DB >> 12350466

Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy.

James D Watterson1, Andrew R Girvan, Darren T Beiko, Linda Nott, Timothy A Wollin, Hassan Razvi, John D Denstedt.   

Abstract

OBJECTIVES: To review the results of holmium laser lithotripsy in a cohort of patients who presented with symptomatic urolithiasis in pregnancy. Symptomatic urolithiasis in pregnancy that does not respond to conservative measures has traditionally been managed with ureteral stent insertion or percutaneous nephrostomy. Holmium:yttrium-aluminum-garnet (YAG) laser lithotripsy using state-of-the-art ureteroscopes represents an emerging strategy for definitive stone management in pregnancy.
METHODS: A retrospective analysis was conducted at two tertiary stone centers from January 1996 to August 2001 to identify pregnant patients who were treated with ureteroscopic holmium laser lithotripsy for symptomatic urolithiasis or encrusted stents. Eight patients with a total of 10 symptomatic ureteral calculi and two encrusted ureteral stents were treated. The mean gestational age at presentation was 22 weeks. The mean stone size was 8.1 mm. The stones were located in the proximal ureter/ureteropelvic junction (n = 3), midureter (n = 1), and distal ureter (n = 6).
RESULTS: Complete stone fragmentation and/or removal of encrusted ureteral stents were achieved in all patients using the holmium:YAG laser. The overall procedural success rate was 91%. The overall stone-free rate was 89%. No obstetric or urologic complications were encountered.
CONCLUSIONS: Ureteroscopy and holmium laser lithotripsy can be performed safely in all stages of pregnancy, providing definitive management of symptomatic ureteral calculi. The procedure can be done with minimal or no fluoroscopy and avoids the undesirable features of stents or nephrostomy tubes.

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Year:  2002        PMID: 12350466     DOI: 10.1016/s0090-4295(02)01751-x

Source DB:  PubMed          Journal:  Urology        ISSN: 0090-4295            Impact factor:   2.649


  20 in total

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Review 4.  Sky is no limit for ureteroscopy: extending the indications and special circumstances.

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6.  The Efficacy and Safety of Laser Lithotripsy in Pregnancy.

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7.  Shock wave lithotripsy versus ureteroscopy for distal ureteral calculi: a prospective study.

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8.  Effectiveness and safety of ureteroscopy in pregnant women: a comparative study.

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9.  Our ultrasonographic experience in the management of symptomatic hydronephrosis during pregnancy.

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10.  Ureteroscopy during pregnancy.

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