Percutaneous Nephrolithotomy in Early Pregnancy

Tóth, Csaba; Tóth, Gabriella; Varga, Attila; Flaskó, Tibor; Salah, Morshed Ali

doi:10.1007/s11255-004-6087-0

Cited by 23 publications

(12 citation statements)

References 9 publications

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“…Although two case reports have described successful PCNL in early pregnancy, the necessity for general anesthesia, need for fluoroscopy, and prone position of the patient make this a hazardous procedure. 87,88 Extracorporeal shockwave lithotripsy (SWL). SWL is contraindicated in pregnancy because of the effects of the shockwave on the fetus, potentially resulting in fetal death.…”

Section: Active Managementmentioning

confidence: 99%

Management of Urinary Calculi in Pregnancy: A Review

Srirangam

Hickerton

Cleynenbreugel

2008

Journal of Endourology

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Nephrolithiasis during pregnancy can represent a clinical dilemma because of potential risks to both mother and fetus. While the incidence of symptomatic nephrolithiasis during pregnancy varies between 1 in 244 to 1 in 2000 pregnancies, the actual incidence is likely to be higher. A significant proportion of patients with asymptomatic renal calculi are detected incidentally in the nonpregnant population compared with pregnant women. Factors that contribute to the diagnostic challenges include anatomic and physiologic changes to the female urinary tract during pregnancy and the limitations on the use of ionizing radiation. The treatment of such patients requires a multidisciplinary team approach involving the urologist, obstetrician, and radiologist. The potential hazards of intervention (either surgical or medical) and anesthesia need to be considered carefully.

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Section: Active Managementmentioning

confidence: 99%

Management of Urinary Calculi in Pregnancy: A Review

Srirangam

Hickerton

Cleynenbreugel

2008

Journal of Endourology

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“…During pregnancy, percutaneous nephrolithotomy (PCNL) is not advised, nonetheless there have been two case reports which informed successful PCNLs in early pregnancy. 20 21 Extracorporeal shockwave lithotripsy is contraindicated in pregnant patients due to the effects of the shockwave on the fetus, which can cause a miscarriage. 22 …”

Section: Discussionmentioning

confidence: 99%

Ureteral Stent Insertion in the Management of Renal Colic during Pregnancy

Choi

Park

2016

Chonnam Med J

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To determine an optimal invasive intervention for renal colic patients during pregnancy after conservative treatments have been found to be unhelpful. Among the available invasive interventions, we investigated the reliability of a ureteral stent insertion, which is considered the least invasive intervention during pregnancy. Between June 2006 and February 2015, a total of 826 pregnant patients came to the emergency room or urology outpatient department, and 39 of these patients had renal colic. The mean patient age was 30.49 years. In this retrospective cohort study, the charts of the patients were reviewed to collect data that included age, symptoms, the lateralities and locations of urolithiasis, trimester, pain following treatment and pregnancy complications. Based on ultrasonography diagnoses, 13 patients had urolithiasis, and 13 patients had hydronephrosis without definite echogenicity of the ureteral calculi. Conservative treatments were successful in 25 patients. Among these treatments, antibiotics were used in 15 patients, and the remaining patients received only hydration and analgesics without antibiotics. Several urological interventions were required in 14 patients. The most common intervention was ureteral stent insertion, which was performed in 13 patients to treat hydronephrosis or urolithiasis. The patients' pain was relieved following these interventions. Only one patient received percutaneous nephrostomy due to pyonephrosis. No pregnancy complications were noted. Ureteral stent insertion is regarded as a reliable and stable first-line urological intervention for pregnant patients with renal colic following conservative treatments. Ureteral stent insertion has been found to be equally effective and safe as percutaneous nephrostomy, which is associated with complications that include bleeding and dislocation, and the inconvenience of using external drainage system.

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“…Although there are some reports regarding utilization of out-of-body lithotripsy (26) and percutaneous lithotripsy (9, 27, 28) with or without using X-ray, ESWL and PCNL yet these methods are still contraindicated in pregnancy according to their probable risk for fetus and their usage is limited to post-delivery period.…”

Section: Discussionmentioning

confidence: 99%

The Evaluation of Ureteroscopy and Pneumatic Lithotripsy Results in Pregnant Women With Urethral Calculi

et al. 2013

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BackgroundUrinary stone incidence in pregnancy has been reported in a wide range, from 1 in 200 to 1 in 2000 cases.ObjectivesThe aim of this study was to investigate the efficacy and safety of ureteroscopic treatment and its results and complications for pregnant women with urinary stones.Patients and MethodsFrom 2003 till 2011, 113 pregnant patients with symptomatic urolithiasis were admitted to the urology emergency clinic at Imam Reza hospital. All patients were initially treated conservatively, resulting in spontaneous passage of the calculi in 69 patients. Forty-four patients with symptomatic urolithiasis were included in the study. Post-operative follow ups, including maternal and fetal health was performed by a gynecologist consult fetal heart rate assessment and urine analysis and culture and renal and urethral ultrasonography.ResultsThe mean age of the patients was 23 years ± 2 (19-34) and the mean gestational age was 24 ± 3 weeks. The overall and pneumatic lithotripsy success rate was 100%. All patients from the interventional group delivered at term with no fetal or maternal complications. There was no morbidity during and after the operation.ConclusionsIn conditions, medical management of urinary stones and consequent renal colic in pregnant women cannot improve patients’ symptoms, choosing of a surgical method like setting of a DJ catheter or URS and pneumatic lithotripsy can be a safe and effective way for the health of both the mother and fetus. Of course, more research is needed to establish this approach as the standard method in pregnancy urinary stones.

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Percutaneous Nephrolithotomy in Early Pregnancy

Cited by 23 publications

References 9 publications

Management of Urinary Calculi in Pregnancy: A Review

Management of Urinary Calculi in Pregnancy: A Review

Ureteral Stent Insertion in the Management of Renal Colic during Pregnancy

The Evaluation of Ureteroscopy and Pneumatic Lithotripsy Results in Pregnant Women With Urethral Calculi

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