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


Submitted: July 9, 2014
Accepted: July 9, 2014
Published: June 30, 2014
Abstract Views: 2506
PDF: 1379
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Authors

  • Senol Adanur 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.
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.

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

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