To investigate the efficacy and safety of minimally invasive surgery in the management of upper ureteral stones during pregnancy.

The clinical data of 127 female patients with upper ureteral calculi during pregnancy from January 2006 to September 2016 were reviewed. The mean age was 29 (range 24~38) years old and the mean pregnancy time was 24 (range 10~36) weeks. All patients complained of typical symptom of renal colic and the conventional treatment was invalid. The postoperative complications were evaluated by modified Clavien classification system and urinary ultrasonography was performed after surgery to evaluate the stone-free rate.

All surgery was successfully performed and the symptom of renal colic was relieved obviously. No serious complication such as threatened abortion or premature delivery, ureteral perforation, avulsion, septic shock or massive hemorrhage was found. Eighty eight patients underwent ureteroscopic holmium laser lithotripsy with a stone-free rate of 85.3%(75/88), 11 patients underwent percutaneous nephrolithotomy under color Doppler guiding, 28 cases underwent the insertion of ureteroscopic double-J tube. The most common postoperative complications were double-J tube irritation, gross hematuria and pain.

The ureteroscopy lithotripsy is safe and feasible with a high stone-free rate. It is not contraindicant in the invasive management of proximal ureteral calculi during pregnancy. Double J tube placement or percutaneous nephrostomy is also a appropriate alteration to relieve renal colic and urinary tract obstruction.