title: Definitive ureteroscopy and intracorporeal lithotripsy in treatment of ureteral calculi during pregnancy.
abstract: OBJECTIVE
  To evaluate the outcome of using semi-rigid ureteroscopy with or without intracorporeal pneumatic lithotripsy vs. temporary ureteric JJ stenting in the management of obstructing ureteric calculi in pregnant women.
  
  
  METHODS
  This prospective comparative study comprised 43 pregnant women with obstructing ureteric calculi. The diagnosis was based on the acute flank pain as the main symptom, microscopic haematuria, and unilateral hydronephrosis on abdominal ultrasonography (US). The patients were randomly divided into two groups; those in group 1 (22 patients) were treated by temporary ureteric JJ stenting until after delivery, and those in group 2 (21) were treated definitively by ureteroscopic stone extraction with intracorporeal pneumatic lithotripsy. Postoperative complications and the degree of patient satisfaction were reported.
  
  
  RESULTS
  An obstructing ureteric stone was identified by US in 68% and 76% of groups 1 and 2, respectively. In group 1, nine patients had mid-ureteric stones and 13 had stones in the lower ureter. In group 2, seven patients had mid-ureteric stones, whilst the stones were in the distal ureter in 14. No perioperative foetal complications were detected in any group and all patients completed the full term of pregnancy. In group 1, four patients had a postoperative urinary tract infection (UTI), and the JJ stent was exchanged in seven. Two patients in group 2 had a postoperative UTI.
  
  
  CONCLUSIONS
  Definitive ureteroscopy, even with intracorporeal pneumatic lithotripsy, is an effective and safe treatment for pregnant women with obstructing ureteric calculi. It has a better outcome and is more satisfactory for the patients than a temporary JJ stent.
authors.affiliation: Urology Department, Zagazig University Hospitals, Zagazig, Sharkia, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Teleb
authors.affiliation: Urology Department, Zagazig University Hospitals, Zagazig, Sharkia, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ragab
authors.affiliation: Urology Department, Zagazig University Hospitals, Zagazig, Sharkia, Egypt.
authors.forename: Tamer
authors.initials: T
authors.lastname: Dawod
authors.affiliation: Urology Department, Zagazig University Hospitals, Zagazig, Sharkia, Egypt.
authors.forename: Hazem
authors.initials: H
authors.lastname: Elgalaly
authors.affiliation: Urology Department, Zagazig University Hospitals, Zagazig, Sharkia, Egypt.
authors.forename: Ehab
authors.initials: E
authors.lastname: Elsayed
authors.affiliation: Urology Department, Zagazig University Hospitals, Zagazig, Sharkia, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Sakr
authors.affiliation: Anesthesiology Department, Zagazig University Hospitals, Zagazig, Sharkia, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdelhameed
authors.affiliation: Urology Department, Zagazig University Hospitals, Zagazig, Sharkia, Egypt.
authors.forename: Arif
authors.initials: A
authors.lastname: Maarouf
authors.affiliation: Urology Department, Zagazig University Hospitals, Zagazig, Sharkia, Egypt.
authors.forename: Salem
authors.initials: S
authors.lastname: Khalil
keywords: Lithotripsy; Pregnancy; Stenting; US, ultrasonography; Ureteric calculi; Ureteroscopy