Ureteroscopy and holmium laser lithotripsy: Is this procedure safe in pregnant women with ureteral stones at different locations?

  • Senol Adanur | s.adanur61@hotmail.com Department of Urology, Medical Faculty, Ataturk University, Turkey.
  • Tevfik Ziypak Department of Urology, Medical Faculty, Ataturk University, Turkey.
  • Fevzi Bedir Department of Urology, Medical Faculty, Ataturk University, Turkey.
  • Turgut Yapanoglu Department of Urology, Medical Faculty, Ataturk University, Turkey.
  • Hasan Riza Aydın Department of Urology, Akçaabat Haçkalı Baba Hospital, Trabzon, Turkey.
  • Mehmet Yılmaz Department of Obstetrics and Gynecology, Medical Faculty, Ataturk University, Turkey.
  • Mehmet Aksoy Department of Anaesthesiology and Reanimation, Medical Faculty, Ataturk University, Turkey.
  • Isa Ozbey Department of Urology, Medical Faculty, Ataturk University, Turkey.

Abstract

Objectives: The aim of this study was to assess the safety and effectiveness of ureteroscopy and Holmium: Yttrium-Aluminum-Garnet lithotripsy for the treatment of ureteral stones with different localizations in symptomatic pregnant women. Methods: A retrospective analysis was performed on 19 pregnant patients referred to our center between January 2005 and December 2012 with symptomatic hydronephrosis requiring surgical intervention. 7.5 F and 9.5 F semirigid ureterorenoscopy with Holmium laser lithotripsy was used for treatment in all patients. Complications were stratified according to modified Clavien criteria. Results: The mean age of patients was 25.4 (18-41) years, and the mean gestation duration was 24.8 (7-33) weeks. Six cases (31.5%) had a history of stone. Solitary kidney secondary to previous nephrectomy was observed in 2 patients and 1 patient had a hypoplastic kidney. Abdominal ultrasonography was used as the main diagnostic tool. Mean stone size was 9.2 mm (6-13). The location of the stones was the lower, middle, and upper ureter in 8 (42.1%), 5 (26.3%) and 6 (31.5%) cases, respectively. All stones were fragmented with Holmium laser lithotripsy. Of the 19 patients, 11 (57.8%) required doublr J stent insertion peroperatively. Intraoperative urological and obstetric complications were not observed. Postoperatively two complications were noted. According to Clavien criteria a complication was level 1, and the other was level 2. Conclusions: For treatment of pregnant women with symptomatic ureteral stones in every location, Holmium laser lithotripsy with a semirigid ureteroscopy can be used as judicious treatment. This approach is effective and safe with an acceptable complication rate.

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Published
2014-06-30
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Section
Original Papers - Urogynecology
Keywords:
Urinary calculi, Pregnancy, Ureteroscopy, Laser lithotripsy
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How to Cite
Adanur, S., Ziypak, T., Bedir, F., Yapanoglu, T., Aydın, H. R., Yılmaz, M., Aksoy, M., & Ozbey, I. (2014). Ureteroscopy and holmium laser lithotripsy: Is this procedure safe in pregnant women with ureteral stones at different locations?. Archivio Italiano Di Urologia E Andrologia, 86(2), 86-89. https://doi.org/10.4081/aiua.2014.2.86