Abstract
The management of stones during pregnancy can be a daunting undertaking for both patient and provider. Ureteroscopy is increasingly utilized as a definitive therapy in this setting. However, the risks—both real and perceived—make this an expedition that can be fraught with anxiety for all parties involved.
Therefore, a review of the background, potential modifications of approach, and fine points of technique is provided. These, and a discussion of potential pitfalls, are addressed in this chapter.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Rodriguez PN, Klein AS. Management of urolithiasis during pregnancy. Surg Gyn Obstet. 1988;166: 103–6.
Lewis DF, Robichaux AG, Jaekle RK, et al. Urolithiasis in pregnancy-diagnosis, management, and pregnancy outcome. J Reprod Med. 2003;48:28–32.
Swartz MA, Lydon-Rochelle MT, Simon D, et al. Admission for nephrolithiasis in pregnancy and risk of adverse birth outcomes. Obstet Gynecol. 2007;109: 1099–104.
Stothers L, Lee LM. Renal colic in pregnancy. J Urol. 1992;148:1383–7.
Coe FL, Parks JH, Lindheimer MD. Nephrolithiasis during pregnancy. N Engl J Med. 1978;298:324–6.
Mhuireachtaigh RN, O’Gorman DA. Anesthesia in pregnant patients for nonobstetric surgery. J Clin Anesth. 2006;18:60–6.
Loughlin KR. Management of urologic problems during pregnancy. Urology. 1994;44:159–69.
Smith CL, Kristensen MD, Abraham PA. An evaluation of the physiochemical risk for renal stone disease during pregnancy. Clin Nephrol. 2001;55:205–11.
Maikranz P, Holley JL, Parks JH, et al. Gestational hypercalciuria causes pathological urine calcium oxalate supersaturations. Kidney Int. 1989;36:108–13.
Maikranz P, Lindheimer M, Coe F. Nephrolithiasis in pregnancy. Baillieres Clin Obstet Gynaecol. 1994;8(2):375–86.
Yatzidis H. Gestational urinary hyperthiosulfaturia protects hypercalciuric normal pregnant women from nephrolithiasis. Int Urol Nephrol. 2004;36: 445–9.
Parulkar BG, Hopkins TB, Wollin MR, et al. Renal colic during pregnancy: a case for conservative treatment. J Urol. 1998;159:365–8.
Travassos M, Amselem I, Filho NS, Miguel M, Sakai A, Consolmagno H, Nogueira M, Fugita O. Ureteroscopy in pregnant women for ureteral stone. J Endourol. 2009;23(3):405–7.
Burgess KL, Gettman MT, Rangel LJ, et al. Diagnosis of urolithiasis and rate of spontaneous passage during pregnancy. J Urol. 2011;186:2280–4.
Preminger GM, Tiselius HG, Assimos DG, et al. Guideline for the management of ureteral calculi. J Urol. 2007;178:2418–34.
Semins MJ, Matlaga BR. Management of stone disease in pregnancy. Curr Opin Urol. 2010;20(2):174–7.
Khoo L, Anson K, Patel U. Success and short-term complication rates of percutaneous nephrostomy during pregnancy. J Vasc Interv Radiol. 2004;15:1469.
ACOG Committee on Obstetric Practice. ACOG Committee opinion no. 474. Non-obstetric surgery during pregnancy. Obstet Gynecol. 2011;117:420–1.
Rosen MA. Management of anesthesia for the pregnant surgical patient. Anesthesiology. 1999;91:1159–63.
Wolf JS, Bennett CJ, Dmochowski RR, et al. Best practice policy statement on urologic surgery antibiotic prophylaxis. J Urol. 2008;179:1379–90.
Bar-Oz B, Moretti ME, Boskovic R, et al. The safety of quinolones-a meta-analysis of pregnancy outcomes. Eur J Obstet Gynecol Reprod Biol. 2009;143:75–8.
Davis SM, Branch DW. Thromboprophylaxis in pregnancy: who and how. Obstet Gynecol Clin North Am. 2010;37:333–43.
Forrest JB, Clemens JQ, Finamore P, et al. AUA best practice statement for the prevention of deep venous thrombosis in patients undergoing urologic surgery. J Urol. 2009;181:1170–7.
ACOG Committee on Obstetric Practice. ACOG Committee opinion no. 299. Guidelines for diagnostic imaging during pregnancy. Obstet Gynecol. 2004;104:647–51.
Loughlin KR. Urologic radiology during pregnancy. Urol Clin North Am. 2007;34:23–6.
Lifshitz DA, Lingeman JE. Ureteroscopy as a first line intervention for ureteral calculi in pregnancy. J Endourol. 2002;16:19.
Cocuzza M, Colombo JR, Lopes RI, et al. Use of Inverted fluoroscope’s c-arm during endoscopic treatment of urinary tract obstruction in pregnancy: a practicable solution to cut radiation. Urology. 2010;75: 1505–8.
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;60:383–7.
Tawfiek ER. Ureteroscopy during pregnancy with follow-the-wire technique. Afr J Urol. 2009;15: 245–9.
Clayman M, Uribe CA, Eichel L, et al. Comparison of guidewires in urology. Which, when, and why? J Urol. 2004;171:2146–50.
Bakke A, Ulvik NM. Ureterorenoscopy in pregnancy. Scand J Urol Nephrol Suppl. 1988;110:243–4.
Polat F, Suleyman Y, Kirac M, et al. Treatment outcomes of semi rigid ureterorenoscopy and intracorporeal lithotripsy in pregnant women with obstructive ureteral calculi. Urol Res. 2011;39:487–90.
Rana AM, Aquil S, Khawaja AM. Semirigid ureteroscopy and pneumatic lithotripsy as definitive management of obstructive ureteral calculi during pregnancy. Urology. 2009;73:964–7.
Marguet CG, Sung JC, Springhart WP, et al. In vitro comparison of stone retropulsion and fragmentation of the frequency doubled, double pulse nd:yag laser and holmium: yag laser. J Urol. 2005;173: 1797–800.
Akpinar H, Tufek I, Alici B, Kural AR. Ureteroscopy and holmium laser lithotripsy in pregnancy: stents must be used postoperatively. J Endourol. 2006;20: 107–10.
Semins MJ, Trock BJ, Matlaga BR. The safety of ureteroscopy during pregnancy: a systematic review and meta-analysis. J Urol. 2009;181(1):139–43.
Johnson EB, Krambeck AE, White WM, et al. Obstetric complications of ureteroscopy during pregnancy. J Urol. 2012;188(1):151–4.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media New York
About this chapter
Cite this chapter
Pais, V.M. (2013). Ureteroscopic Management of Stones During Pregnancy. In: Monga, M. (eds) Ureteroscopy. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-206-3_32
Download citation
DOI: https://doi.org/10.1007/978-1-62703-206-3_32
Published:
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-62703-205-6
Online ISBN: 978-1-62703-206-3
eBook Packages: MedicineMedicine (R0)