Abstract
Introduction
Ureteric colic in pregnancy is one of the common non-obstetric reasons for emergency department visits. Ureteric calculi present a significant threat to maternal and fetal health and definitive management often becomes necessary. Our aim is to assess the safety and efficacy of ureteroscopic laser lithotripsy in the management of ureteric stones in pregnancy.
Material and methods
This is a prospective observational study of 3 years carried at a tertiary referral center. It includes all pregnant patients who underwent ureteroscopic laser lithotripsy for ureteric stones.
Results
A total of 29 pregnant patients underwent ureteroscopic laser lithotripsy at our center in 3 years. The mean age of patients was 33.5 ± 6.2 years, and the mean gestation age at the time of ureteroscopy was 23.34 ± 5.9 weeks. The average stone size was 8.3 ± 3.6 mm and was predominantly found in upper ureter (62%). The mean operative time was 31 ± 8.9 min, and the average laser energy spent was 4.3 ± 1.1 kJ/case. There was no major Intraoperative complication, and the average hospital stay was 2.5 ± 1.5 days. Complete stone clearance was achieved in 93.1% of cases.
Conclusion
Ureteroscopic laser lithotripsy is safe and effective treatment of ureteric stones in terms of obstetric outcome and stone clearance in pregnancy.
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Abbreviations
- CT:
-
Computed tomography
- DJ:
-
Double J
- MRU:
-
Magnetic resonance urography
- Ho:YAG:
-
Holmium yttrium garnet
- USG:
-
Ultrasonography
References
Rodriguez PN, Klein AS. Management of urolithiasis in pregnancy. Surg Gynecol Obstet. 1988;166:103–6.
Maikranz P, Lindheimer M, Coe F. Nephrolithiasis in pregnancy. Baillieres Clin Obstet Gynaecol. 1994;8:375–86.
Sefa R, Cetin EH, Gurkan K, Metin K. Are changes in urinary parameters during pregnancy clinically significant? Urol Res. 2006;34(4):244–8.
Somani BK, Dellis A, Liatsikos E, Skolarikos A. Review on diagnosis and management of urolithiasis in pregnancy: an ESUT practical guide for urologists. World J Urol. 2017;35(11):1637–49.
Juan YS, Wu WJ, Chuang SM, Wang CJ, et al. Management of symptomatic urolithiasis during pregnancy. Kaohsiung J Med Sci. 2007;23:241–6.
Andreoiu M, MacMahon R. Renal colic in pregnancy: lithiasis or physiological hydronephrosis? Urology. 2009;74(4):757–61.
Elgamasy A, Elsherif A. Use of Doppler ultrasonography and rigid ureteroscopy for managing symptomatic ureteric stones during pregnancy. BJU Int. 2010;106(2):262–6.
Mullins JK, Semins MJ, Hyams ES, et al. Half fourier single shot turbo spin echo magnetic resonance urography for the evaluation of suspected renal colic in pregnancy. Urology. 2012;79(6):1252–5.
Dellabella M, Milanese G, Muzzonigro G. Randomized trial of the efficacy of tamsulosin, nifedipine and phloroglucinol in medical expulsive therapy for distal ureteral calculi. J Urol. 2005;174:67.
Lifshitz DA, Lingeman JE. Ureteroscopy as a first line intervention for ureteral calculi in pregnancy. J Endourol. 2002;16:19–22.
Cheek TG, Baird E. Anesthesia for nonobstetric surgery: maternal and fetal considerations. Clin Obstet Gynecol. 2009;99:535–45.
Ulvik NM, Bakke A, Hoisaeter PA. Ureterscopy in pregnancy. J Urol. 1995;154(5):1660–3.
Upadya M, Saneesh PJ. Anaesthesia for non-obstetric surgery during pregnancy. Indian J Anaesth. 2016;60(4):234–41.
Norwitz ER, Robinson JN, Challis JRG. The control of labor. N Engl J Med. 1999;341:660–6.
Watterson JD, Girvan AR, Beiko DT, et al. Ureteroscopy and holmium: yag laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy. Urology. 2002;60(3):383–7.
Bozkurt Y, Soylemez H, Atar M, et al. Effectiveness and safety of ureteroscopy in pregnant women: a comparative study. Urolithiasis. 2013;41(1):37–42.
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This study has been approved by the institution ethical committee of our institute with IEC number #OA/212/2020. This study is designed and performed according to the Declaration of Helsinki.
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Shayista Gull is a Senior resident, Sajad Ahmad Para is a Assistant professor, Shashank Singh is a Post doctorate trainee, Faiz Manzar Ansari is a Post doctorate trainee, Manjul Kumar is a Post doctorate trainee, Waseem Ashraf is a Post doctorate trainee.
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Gull, S., Para, S.A., Singh, S. et al. Safety and Efficacy of Ureteroscopic Laser Lithotripsy in the Management of Ureteric Calculi in Pregnancy–Experience of a Tertiary Care Center. J Obstet Gynecol India 74, 131–135 (2024). https://doi.org/10.1007/s13224-023-01889-y
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DOI: https://doi.org/10.1007/s13224-023-01889-y