Distal ureteral calculi: detection with vaginal US.

Laing, F C; Benson, Carol B.; DiSalvo, D N; Brown, Diane; Frates, Mary C.; Loughlin, Kevin R.

doi:10.1148/radiology.192.2.8029429

Cited by 128 publications

(57 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Laing et al reported detection of 13 distal ureteral stones, where transabdominal scan had detected only two of the 13 stones. 41 Sensitivity for stone detection may also be improved in pregnancy by using Doppler US to measure renal vascular resistance. Measurement of the resistive index (RI) of intrarenal blood flow has shown that using a threshold of 0.70 for RI and a change in RI of 0.06 is useful in the diagnosis of acute unilateral ureteral obstruction, if done within 6-48 h of presentation (sensitivity 45%, specificity 91% and sensitivity 95%, specificity 100%, respectively).…”

Section: Ultrasonographymentioning

confidence: 99%

Renal stones in pregnancy

2014

View full text Add to dashboard Cite

Diagnosis and treatment of renal stones during pregnancy is a complex problem. Risks to the fetus from ionising radiation and interventional procedures need to be balanced with optimising clinical care for the mother. Management of such patients requires a clear understanding of available options, with a multidisciplinary team approach. In this review, we discuss the role of different diagnostic tests including ultrasound, magnetic resonance urography, and computerized tomography. We also provide an update on recent developments in the treatment of renal stones during pregnancy. Expectant management remains first-line treatment. Where definitive treatment of the stone is required, new evidence suggests that ureteroscopic stone removal may be equally safe, and possibly better than traditional temporising procedures.

show abstract

Section: Ultrasonographymentioning

confidence: 99%

Renal stones in pregnancy

2014

View full text Add to dashboard Cite

show abstract

“…Nestes casos deve-se utilizar a US e a RM como métodos de rastreamento e detalhamento anatômico. A US é bastante sensível para a detecção de cálculos nas vias urinárias, perdendo em eficácia quando o cálculo encontra-se localizado no ureter distal; nestes casos a US endovaginal pode ser alternativa diagnós-tica eficiente (31) . Quando a urografia excretora é indispensável pode-se reduzir a dose de radiação realizando-se apenas uma radiografia dez minutos após a injeção endovenosa do contraste; desta forma, é possí-vel identificar os sistemas coletores e eventuais obstruções.…”

Section: Exames Radiológicos Durante a Gestaçãounclassified

Exames radiológicos na gestação

D'Ippólito

Medeiros

2005

Radiol Bras

View full text Add to dashboard Cite

Gestantes podem precisar ser submetidas a exames radiológicos para um diagnóstico preciso e conduta correta. Nestes casos a exposição à radiação ionizante e seus efeitos sobre o feto são motivo de preocupação para a paciente e o seu médico. Na verdade, a maioria destes exames é segura e não oferece risco significativo ao feto. No entanto, é importante que o radiologista conheça estes riscos potenciais para poder orientar adequadamente todos os envolvidos no atendimento. Unitermos: Radiação ionizante; Gestação; Tomografia computadorizada; Exame radiológico.X-ray examinations during pregnancy. X-ray examinations may be necessary during pregnancy for an accurate diagnosis and adequate treatment administration. In these cases, the exposure to ionizing radiation and its effects on the fetus are a major concern to the patient and to the clinician. In fact, most of these examinations are safe and do not represent a significant risk to the fetus. However, the radiologist must know the potential risks to be able to instruct all personnel involved in the care of the patient. Key words: Ionizing radiation; Pregnancy; Computed tomography; X-ray studies. Atualização feto, permite medir os riscos e justificar a utilização de determinados métodos radiológicos em benefício da gestante. Resumo DEFINIÇÃO E MENSURAÇÃO DA RADIAÇÃO IONIZANTEQualquer discussão a respeito dos efeitos da radiação ionizante prescinde de uma clara compreensão sobre o que é a radiação ionizante e como esta é medida (dosimetria). Podemos definir a radiação ionizante como ondas eletromagnéticas de alta energia (raios X ou raios gama) que, ao interagirem com a matéria, desencadeiam uma série de ionizações, transferindo energia aos átomos e moléculas presentes no campo irradiado e promovendo, assim, alterações físico-químicas intracelulares (7) . Para se entender os efeitos relacionados à exposição à radiação ionizante deve-se definir as grandezas físicas utilizadas para quantificá-la. Com o objetivo de se medir a energia depositada por um feixe de fótons de alta energia (raios X ou raios gama) em um tecido biológico e os seus efeitos sobre este tecido, foi criada a grandeza "dose absorvida". A dose absorvida de radiação é a energia depositada por quilograma de tecido e é expressa em "rad" ("radiation absorbed dose", ou dose de radiação absorvida). Pelo sistema internacional de medidas utiliza-se a unidade "gray" (Gy), que equivale a 100 rad. Ela é adotada para qual- INTRODUÇÃOExames de diagnósticos por imagem são freqüentemente realizados durante a gestação para avaliar afecções maternas preexistentes, inerentes à gravidez ou relacionadas ao feto. Os métodos mais difundidos são aqueles com pouco ou nenhum efeito sobre o feto, tais como a ultra-sonografia (US) e, mais recentemente, a ressonância magnética (RM)(1-3) . Os exames radiológi-cos são geralmente relegados a um segundo plano e eventualmente descartados ou adiados, em virtude da apreensão gerada pelos potenciais riscos à saúde do feto; no entanto, um diagnóstico postergado ou perdido, em função da não...

show abstract

“…The second limitation is the impossibility of evaluating the ureter below the level of the pelvic brim/iliac artery in most cases as well as situations in which the 289 Archivio Italiano di Urologia e Andrologia 2017; 89, 4 Ureteroscopy in pregnant women and premature labor investigator is unable to differentiate between secondary ureteral obstruction from calculi and the physiologic hydronephrosis of pregnancy (14). Transvaginal USG is another diagnostic tool that can be used to accurately detect distal ureteral stones as demonstrated in the literature and can be performed to evaluate the length of the uterine cervix in a one-step procedure (15). In pregnant patients, ionizing radiation may have teratogenic effects on the fetus and should be avoided, diminishing clinicians' diagnostic options in complicated cases.…”

Section: Discussionmentioning

confidence: 99%

Ureteroscopy in pregnant women with complicated colic pain: Is there any risk of premature labor?

Butticè

Laganà

Vitale

et al. 2017

Arch Ital Urol Androl

View full text Add to dashboard Cite

Objective: Clinical presentation of ureteral stones during pregnancy is generally with renal colic pain. The aim of this study is to present our experience in the management of renal colic during pregnancy in emergency settings. Materials and methods: 208 pregnant patients who presented to emergency department with renal colic pain and underwent ureteroscopy (URS) due to failed conservative therapy were enrolled in the study. Urinary tract stones were diagnosed either with ultrasound (US) examination or during URS. Laser lithotripsy and double J (DJ) stent placement were routinely done in all patients with ureteral stones. The incidence of infective complications and premature uterine contractions (PUC) due to URS were compared. Results: No stone was identified in 36.1% (n = 75) of patients with using US and diagnostic URS. Of the remaining 133 patients, 30 (22.6%) had no stone at US but stones were diagnosed during diagnostic URS. The type of anesthesia had no significant effect on PUC. An increased risk of sepsis and PUC was found in patients with fever at the initial presentation. Interestingly, PUC was more frequent in patients with lower serum magnesium levels. There was a significant correlation with time delay until the intervention and the risk of urosepsis and PUC, individually. Conclusions: Ureteroscopy is a safe option for evaluation of pregnant patients with unresolved renal colic. According to the current findings, timing of the operation is the most important factor affecting the septic risks and abortion threat. Surgical intervention with URS must be planned as soon as possible.KEY WORDS: Pregnancy; Urinary calculi; Renal colic. 0.02-0.53%, complicating from 1:200 to 1:2000 pregnancies, and urolithiasis may also be a contributing factor in up to 40% of premature births (2). Several elements are capable of increasing the risk of urolithiasis and hydronephrosis during pregnancy, including the mass-effect of gravid uterus, reduced peristalsis and dilation of the urinary tract due to elevated progesterone levels, and increased risk of infection and electrolyte imbalance (decreased secretion of urinary stone inhibitors, such as citrate and magnesium) (3). Renal colic is the most common non-obstetric cause of abdominal pain and subsequent hospitalization during pregnancy (3). The clinical presentation of ureteral stones during pregnancy is primarily after 20 weeks of gestation; alongside renal colic, tenderness, fever, dull aching pain and hematuria (4). As is the case with the general population, a conservative approach that makes use of analgesia and monitoring for spontaneous passage is often the most appropriate initial treatment for acute renal colic in the pregnant patient. However, if spontaneous passage does not occur or if complications develop, placement of a ureteral stent or a percutaneous nephrostomy is necessary. In such cases, ureteroscopy (URS) has also become a reasonable alternative due to patients' low tolerance for these devices (5). The aim of this study is to present our experience...

show abstract

Distal ureteral calculi: detection with vaginal US.

Abstract: In symptomatic female patients, use of vaginal sonography should be considered to evaluate the distal ureter for calculi, particularly if the results of transabdominal examination are normal or inconclusive.

Cited by 128 publications

References 0 publications

Renal stones in pregnancy

Renal stones in pregnancy

Exames radiológicos na gestação

Ureteroscopy in pregnant women with complicated colic pain: Is there any risk of premature labor?

Contact Info

Product

Resources

About