Management of stone disease in pregnancy

Michelle J. Semins, Brian R. Matlaga

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of Review: Nephrolithiasis is a not infrequent complication of pregnancy. The occurrence of a stone event in a pregnant woman is a complex situation. Therefore, a clear understanding of the management options available and their relative advantages and disadvantages for this unique population is important. Recent Findings: When initial, conservative measures have failed in the treatment of a pregnant woman suffering from an acute stone event, management options have historically been of a temporizing nature: generally, either ureteral stent placement or nephrostomy drainage. However, with recent advances in surgical technology and surgeon technique, a more definitive approach to these patients has become more widely adopted. Indeed, several recent case series have reported the complication rate for ureteroscopy during pregnancy to be low. Furthermore, a meta-analysis of case series of ureteroscopy during pregnancy suggests definitive endoscopic treatment is well tolerated in this patient population. Summary: In a pregnant patient without contraindications to ureteroscopy, the definitive endoscopic treatment of an acute stone event is a reasonable management strategy, should conservative measures fail. Although further investigation with randomized control trials is ideally needed to confirm these results, at present, the published case series and meta-analysis confirm the safety of ureteroscopy in pregnant patients in the appropriate setting. A multidisciplinary approach is key to the successful management of this complex patient population.

Original languageEnglish (US)
Pages (from-to)174-177
Number of pages4
JournalCurrent opinion in urology
Volume20
Issue number2
DOIs
StatePublished - Mar 1 2010

Keywords

  • Calculi
  • Kidney
  • Nephrostomy
  • Pregnancy
  • Ureteroscopy

ASJC Scopus subject areas

  • Urology

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