Ureteroscopy in pregnant women with complicated colic pain: Is there any risk of premature labor?


Submitted: August 31, 2017
Accepted: October 23, 2017
Published: December 31, 2017
Abstract Views: 2107
PDF: 903
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Authors

  • Salvatore Butticè Department of Human Pathology - Section of Urology, University of Messina, Messina, Italy.
  • Antonio Simone Laganà Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy.
  • Salvatore Giovanni Vitale Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy.
  • Christopher Netsch Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
  • Yiloren Tanidir Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey.
  • Francesco Cantiello Department of Urology, Magna Graecia University, Catanzaro, Italy.
  • Laurian Dragos Clinical Emergency County Hospital "Pius Branzeu" Timisoara, University of Medicine and Pharmacy "Victor Babes" Timisoara, Romania.
  • Michele Talso Department of Urology, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Italy.
  • Esteban Emiliani Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie Paris VI, Paris, France; Groupe de Recherche Clinique sur la Lithiase Urinaire, GRC n° 20, Sorbonne Universités, Paris VI, France., France.
  • Rosa Pappalardo Department of Human Pathology – Section of Urology, University of Messina, Messina, Italy.
  • Tarik Emre Sener Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey.
Objective: Clinical presentation of ureteral stones during pregnancy is generally with renal colic pain. The aim of this study is to present our experience in the management of renal colic during pregnancy in emergency settings. Materials and methods: 208 pregnant patients who presented to emergency department with renal colic pain and underwent ureteroscopy (URS) due to failed conservative therapy were enrolled in the study. Urinary tract stones were diagnosed either with ultrasound (US) examination or during URS. Laser lithotripsy and double J (DJ) stent placement were routinely done in all patients with ureteral stones. The incidence of infective complications and premature uterine contractions (PUC) due to URS were compared. Results: No stone was identified in 36.1% (n = 75) of patients with using US and diagnostic URS. Of the remaining 133 patients, 30 (22.6%) had no stone at US but stones were diagnosed during diagnostic URS. The type of anesthesia had no significant effect on PUC. An increased risk of sepsis and PUC was found in patients with fever at the initial presentation. Interestingly, PUC was more frequent in patients with lower serum magnesium levels. There was a significant correlation with time delay until the intervention and the risk of urosepsis and PUC, individually. Conclusions: Ureteroscopy is a safe option for evaluation of pregnant patients with unresolved renal colic. According to the current findings, timing of the operation is the most important factor affecting the septic risks and abortion threat. Surgical intervention with URS must be planned as soon as possible.

Butticè, S., Laganà, A. S., Vitale, S. G., Netsch, C., Tanidir, Y., Cantiello, F., Dragos, L., Talso, M., Emiliani, E., Pappalardo, R., & Sener, T. E. (2017). Ureteroscopy in pregnant women with complicated colic pain: Is there any risk of premature labor?. Archivio Italiano Di Urologia E Andrologia, 89(4), 287–292. https://doi.org/10.4081/aiua.2017.4.287

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