Urolithiasis in pregnancy.
BACKGROUND
The aim of this study was to review our experience in the diagnosis and management of urolithiasis in pregnant women, and to discuss safety, appropriate diagnostic tools and treatment modalities with review of literatures.


METHODS
Nine women with pregnancy proved to have urolithiasis were included in this study. The diagnosis was made according to their symptoms and signs, and ultrasonographic findings. Conservative treatment with hydration, analgesics and antibiotics was applied initially, followed by some minimally invasive procedures, including percutaneous nephrostomy (PCN), double J (DBJ) stenting and ureterorenoscopy (URS), if initial treatment failed.


RESULTS
All patients received conservative treatment at first, and 4 patients got well till delivery, another 5 patients needed further minimally invasive procedures; 1 of them received DBJ stenting, another 1 received PCN first and changed to DBJ stenting. The remaining 3 patients were treated by ureterorenoscopy with stone manipulation. All these 5 patiens had full-term delivery without obstetric sequela, except 1 patient who received left salpingoophrectomy due to left ovarian abscess.


CONCLUSIONS
During pregnancy, urolithiasis is a diagnostic and therapeutic challenge. Clinical symptoms and signs are most important in establishing diagnosis, and ultrasound examination adds accuracy. Minimally invasive procedures (such as PCN, DBJ stenting, URS) can facilitate the successful management of patients requiring further intervention due to failure of conservative treatment.
Yang
Ching-Hwa
CH
Divison of Urology, Department of Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan, ROC.
Chan
Pei-Hui
PH
La
Siu-Kei
SK
Chang
Hsiao-Chun
HC
Chiu
Bin
B
Lin
Hsien-Ming
HM
Sheu
Ming-Huei
MH
D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008096:Lithotripsy; D019060:Minimally Invasive Surgical Procedures; D009403:Nephrostomy, Percutaneous; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D015607:Stents; D016216:Ultrasonography, Prenatal; D014545:Urinary Calculi / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy