Ureteroscopic management of pregnant patients with persistent renal colic

doi:10.3877/cma.j.issn.1674-3253.2020.04.007

Abstract

Abstract:

Objective

To present our experiences of the ureteroscopic management for the treatment of pregnant patients with persistent renal colic.

Methods

Between March 2017 and September 2018, the data of seventy-eight pregnant women who had persistent renal colic and were treated with ureteroscopy were retrospectively analyzed. Patients were divided into three groups due to the period of the persistent renal colic: Group A (less than 6 hours, 16 cases), Group B (>6, but <12 hours, 51 cases) and Group C (>24 hours, 9 cases). The stone-free rate, complications, as well as other operative data were analyzed.

Results

Fifty-eight cases (74.3%) were found ureteral stone during ureteroscopy. They were treated by ureteroscopic lithotripsy (URSL) and DJ stent insertion. 27.6% of them were not identified with ureteral calculi preoperative transabdominal ultrasound. The stone-free rate was 87.9%. The other 20 cases with renal pelvic stone were introduced DJ stent after ureteroscopy. Renal colic were absent in all case after ureteroscopic management. Cases 9(11.5%) suffered froma threatened abortion. The rates of threatened abortion in Groups A, B and C were 6.25%, 7.55%, 44.4%, respectively. Patients in Group C had higher abortion rate (P<0.05). One patient (6.25%) who suffered urosepsis in Group C was recovered after antibacterial therapy. There were no postpartum infant and maternal complications.

Conclusion

For pregnant patients with persistent renal colic, ureteroscopy is an effective and safe options. Early performing can reduce the risk of preterm birth.

Key words: Pregnant, Renal colic, Stone, Ureteroscopy

Wei Xu, Dehui Lai, Ming Sheng, Weiqing Yang, Xun Li. Ureteroscopic management of pregnant patients with persistent renal colic[J]. Chinese Journal of Endourology(Electronic Edition), 2020, 14(04): 266-269.

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References 18

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?	A组	B组	C组	P值
例数	16	53	9	?
年龄（岁，±s）	28±3	27±5	27±6	0.25
BMI（kg/m²，±s）	21.9±2.3	20.6±3.3	20.9±3.3	0.23
平均孕周（周，±s）	22.2±1.3	25.6±3.3	23.4±4.3	0.63
妊娠期（中期/晚期，例）	12/4	40/13	6/3	0.41
肾积水程度（轻/中，例）	3/13	15/38	3/6	0.13
积水侧（左/右，例）	5/11	26/27	4/5	0.14
术前彩超诊断输尿管结石（例）	10	27	5	0.36
结石位置（上/中/下，例）	2/4/4	6/12/9	1/4/0	0.07
结石直径（cm，±s）	0.9±0.3	1.1±0.5	0.8±0.3	0.52
术中镜检诊断输尿管结石（例）	15	34	9	0.07
结石位置（上/中/下，例）	2/7/6	9/16/9	1/6/2	0.14
钬激光碎石（例）	10	29	5	0.09
碎石时间（min，±s）	11.3±1.2	12.4±2.2	10.9±3.2	0.65
手术时间（min，±s）	18.5±6.3	20.1±4.3	21.3±5.2	0.77
结石清除率（%）	86.7%	87.8%	90%	0.12
分娩前留置支架（例）	12	47	5	0.36
中段尿培养阳性（例）	4	9	2	0.09
尿源性脓毒血症（例）	0	1	0	0.57
先兆流产（例）	1	4	4	0.02
胎儿畸形（例）	0	1	0	0.82

?	A组	B组	C组	P值
例数	16	53	9	?
年龄（岁，±s）	28±3	27±5	27±6	0.25
BMI（kg/m²，±s）	21.9±2.3	20.6±3.3	20.9±3.3	0.23
平均孕周（周，±s）	22.2±1.3	25.6±3.3	23.4±4.3	0.63
妊娠期（中期/晚期，例）	12/4	40/13	6/3	0.41
肾积水程度（轻/中，例）	3/13	15/38	3/6	0.13
积水侧（左/右，例）	5/11	26/27	4/5	0.14
术前彩超诊断输尿管结石（例）	10	27	5	0.36
结石位置（上/中/下，例）	2/4/4	6/12/9	1/4/0	0.07
结石直径（cm，±s）	0.9±0.3	1.1±0.5	0.8±0.3	0.52
术中镜检诊断输尿管结石（例）	15	34	9	0.07
结石位置（上/中/下，例）	2/7/6	9/16/9	1/6/2	0.14
钬激光碎石（例）	10	29	5	0.09
碎石时间（min，±s）	11.3±1.2	12.4±2.2	10.9±3.2	0.65
手术时间（min，±s）	18.5±6.3	20.1±4.3	21.3±5.2	0.77
结石清除率（%）	86.7%	87.8%	90%	0.12
分娩前留置支架（例）	12	47	5	0.36
中段尿培养阳性（例）	4	9	2	0.09
尿源性脓毒血症（例）	0	1	0	0.57
先兆流产（例）	1	4	4	0.02
胎儿畸形（例）	0	1	0	0.82

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