Renal Colic During Pregnancy: A Case for Conservative Treatment

Parulkar, Bhalchandra G.; Hopkins, Timothy B.; Wollin, Myron; Howard, P. J.; Lal, Ann K.

doi:10.1016/s0022-5347(01)63918-1

Cited by 128 publications

(81 citation statements)

References 12 publications

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“…2 It was estimated that there is one case of urolithiasis requiring active treatment in every 1500 pregnancies. 9 Fifty to 80% of stones during pregnancy pass spontaneously with conservative treatment 4 but, 20% to 30% of cases will need some form of active treatment such as placing a percutaneous nephrostomy (PCN) tube or performing ureteroscopic procedures. 10 The purpose of the treatment is to diminish maternal pain, to prevent renal dysfunction and urinary tract infection and to decrease obstetric complications.…”

Section: Discussionmentioning

confidence: 99%

“…Placing nephrostomy tube in pregnancy has similar complications. 12,16,17 In the study of Parulkar et al 4 20 all types of stones with varying compositions can be fragmented into relatively small particles which can be easily eliminated. 21 Holmium laser lithotripters compared with pneumatic lithotripters, produce weak shock waves with minimal tissue penetration, thus theoretically limiting the risk of fetal injury.…”

Section: Discussionmentioning

confidence: 99%

“…2 Between 80% to 90% of urinary stones during pregnancy are diagnosed in the second or third trimesters. 3 Fifty to 80% of stones during pregnancy tend to pass spontaneously with conservative treatment, 4 but patients whose renal colic did not resolve despite conservative treatment during follow-up period underwent ureterorenoscopy (URS). 5 The main benefit of URS is visualization of the ureter and renal pelvis that enables detection and treatment of ureteral stones.…”

Section: Introductionmentioning

confidence: 99%

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The Efficacy and Safety of Laser Lithotripsy in Pregnancy

et al. 2017

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Introduction: The aim of our study was to assess the efficacy and safety of laser lithotripsy in pregnant patients. Methods: In this retrospective study, we reviewed the 15 pregnant women who have been treated for ureteral stones with semi-rigid ureteroscope and holmium laser at our center between Januarys 2007and April 2015. Results:The mean age of patients and mean gestational age was 29.3 years old 27.3 weeks respectively. Mean size of stones was 7.84 mm. Twelve patients had renal colic, and hematuria was found in 3 cases. Irritative urinary symptoms such as frequency and urgency detected in 6 ones and 2 patients had fever. The stone of all patients were fragmented by using holmium laser lithotripter. In 5 patients stone residual fragments were removed by grasper while other 10 patients were left to pass fragments spontaneously. No intraoperative and postoperative urological or obstetric complication was seen. Conclusion: Laser lithotripsy is safe and efficacious in pregnant patients who have ureteral stone that does not respond to conservative management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Efficacy and Safety of Laser Lithotripsy in Pregnancy

et al. 2017

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“…However, Stothers and Lee reported that microscopic hematuria is not evident in 25% of patients with diagnosed calculi. 6 Parulkar et al diagnosed lithiasis in 40 of 66 pregnancies with hematuria 11 and concluded that microscopic hematuria is not discriminatory for diagnosing calculi, and despite being a frequent sign, it is not specific.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound sensitivity for the diagnosis of urinary lithiasis varies between 34% 12 and 98%. 6 Parulkar et al demonstrated a sensitivity of 95.2% 11 for diagnosis of middle ureter lithiasis.…”

mentioning

confidence: 99%

Ureteroscopy in Pregnant Women for Ureteral Stone

Travassos

Amselem

Filho

et al. 2009

Journal of Endourology

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Introduction: The occurrence of urolithiasis in pregnancy represents a challenge in both diagnosis and treatment of this condition, because it presents risks not only to the mother but also to the fetus. Surgical treatment may be indicated for patients with infection, persistent pain, and obstruction of a solitary kidney. We present our experience on the management of pregnant patients with ureteral calculi and a review of the literature. Materials and Methods: The charts of 19 pregnant patients with obstructive ureteral calculi were retrospectively reviewed. Gestational age ranged from 13 to 33 weeks. In all patients, ureteral stone was diagnosed on abdominal ultrasound. In regard to localization, 15 calculi were in the distal ureter, 3 in the proximal ureter, and 1 in the interior of an ureterocele. Calculi size ranged from 6 to 10 mm (mean, 8 mm). The following criteria were used to indicate ureteroscopy: persistent pain with no improvement after clinical treatment, increase in renal dilation, or presence of uterine contractions. Nine patients (47.3%) were submitted to ureteroscopy. All calculi (100%) were removed with a stone basket extractor under continuous endoscopic vision. None of the calculi demanded the use of a lithotriptor. Results: Nine patients (47.3%) treated with clinical measurements presented no obstetric complications and spontaneous elimination of the calculi. Nine patients (47.3%) submitted to ureteroscopy had no surgical complications. There was remission of pain in all cases after ureteroscopy and ureteral catheter placement. Conclusion: The diagnosis and treatment of ureteral lithiasis in pregnant women present potential risks for the fetus and the mother. Conservative management is the first option, but ureteroscopy may be performed with safety and high success rates.

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CT Scanning in Pregnancy

Litmanovich

Bankier

2012

Radiation Dose From Multidetector CT

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Renal Colic During Pregnancy: A Case for Conservative Treatment

Cited by 128 publications

References 12 publications

The Efficacy and Safety of Laser Lithotripsy in Pregnancy

The Efficacy and Safety of Laser Lithotripsy in Pregnancy

Ureteroscopy in Pregnant Women for Ureteral Stone

CT Scanning in Pregnancy

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