https://doi.org/10.4081/aiua.2024.12153
Surgical management of obstructing ureteral stones during pregnancy: A systematic review of different techniques
Submitted: March 30, 2024
Accepted: April 21, 2024
Published: October 2, 2024
Accepted: April 21, 2024
Abstract Views: 1176
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Introduction: Renal colic is the most common non-obstetric cause of abdominal pain during pregnancy and is associated with a higher risk of complications in these women. When invasive treatment is required, options are temporary drainage with ureteral stent (JJ) or percutaneous nephrostomy (PCN), or immediate definitive treatment with ureteroscopy (URS). Our goal was to review the safety and efficacy of these procedures in treating urolithiasis during pregnancy.
Methods: Adhering to the PRISMA checklist guidelines, we searched PubMed, Embase, and Scopus databases for articles on the efficacy and complications of the three procedures in pregnant women. The quality of evidence and risk of bias were evaluated using the Critical Appraisal Skills Programme and the Institute of Health Economics tools.
Results: We included 45 articles, totaling 3424 interventions in pregnant women - 2188 URS, 719 JJ, and 517 PCN. URS was the most assessed procedure, with stone-free rates comparable to the non-pregnant patients. The most frequent complications were lower urinary symptoms and infections independently of the intervention. Obstetric complications for all interventions included 167 cases of preterm labor, resulting in 24 premature births. No statistically significant differences in post-operative complications were reported between the procedures in the few comparative studies.
Conclusions: Despite the absence of high-quality studies, current evidence suggests that URS, JJ, and PCN are all safe and effective during pregnancy. As most patients submitted to temporary drainage require a second procedure post-delivery, primary URS appears more efficient. Therefore, it is the preferred option unless there are indications for temporary drainage.
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How to Cite
Laranjo Tinoco, C., Oliveira, M. J., Araújo, A. S., Cardoso, A., Oliveira, C., Mota, P., & Pimentel Torres, J. (2024). Surgical management of obstructing ureteral stones during pregnancy: A systematic review of different techniques. Archivio Italiano Di Urologia E Andrologia, 96(3). https://doi.org/10.4081/aiua.2024.12153
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