#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Urolithiasis in pregnancy


Authors: Jan Vlnieška;  Aleš Petřík
Authors‘ workplace: Urologické oddělení Nemocnice České Budějovice, a. s., České Budějovice
Published in: Ces Urol 2022; 26(2): 90-98
Category: Review articles

Overview

Renal colic is the most common non obstetric cause of hospital admission in pregnancy. Ideal managementof urinary stones which ensure the good condition of the mother and fetus is a challenge to urologists and gynecologists. There are several anatomical and functional changes in the urogenital tract of pregnant women, which lead to calculi formation. The most common symptom of ureteral stone is flank pain with microscopic or macroscopic hematuria. Inonizing imaging modalities should be avoided if is possible in pregnant women. Ultrasound is the first line imaging of choice. It is non invasive, low cost and generally available. Upper urinary tract dilatation can be reliably detected with ultrasound. MRI can be used to detect ureteral stones not seen on ultrasound. When MRI is not available, low dose CT seems to be safe option, but only as last resort when imaging before endoscopic intevention is required by the treating urologist. Conservative managment, with observation and waiting for spontaneous passage is the preferred first line option for ureteral stones in pregnancy. In refractory renal colic, or if febrile UTI develops with stone obstruction, urological intervention (with or without stone treatment) and stent insertion is required.

Keywords:

treatment – pregnancy – diagnostic imaging – urolithiasis


Sources

1. Masselli G, Weston M, Spencer J. The role of imaging in the diagnosis and management of renal stone disease in pregnancy. Clin Radiol. 2015; 70(12): 1462–1.

2. Semins MJ, Matlaga BR. Management of stone disease in pregnancy. Curr Opin Urol. 2010; 20(2): 174–7.

3. Biyani CS, Joyce AD. Urolithiasis in pregnancy. I: pathophysiology, fetal considerations and diagnosis. BJU Int. 2002; 89(8): 811–8; quiz i‑ii.

4. Blanco LT, Socarras MR, Montero RF, et al. Renal colic during pregnancy: Diagnostic and therapeutic aspects. Literature review. Cent European J Urol. 2017; 70(1): 93–100.

5. Valovska MI, Pais VM, Jr. Contemporary best practice urolithiasis in pregnancy. Ther Adv Urol. 2018; 10(4): 127–38.

6. Resim S, Ekerbicer HC, Kiran G, et al. Are changes in urinary parameters during pregnancy clinically significant? Urol Res. 2006; 34: 244–248.

7. Cormier CM, Canzoneri BJ, Lewis DF, et al. Urolithiasis in pregnancy: current diagnosis, treatment, and pregnancy complications. Obstet Gynecol Survey. 2006; 61(11): 733–741.

8. Evans HJ, Wollin TA. The management of urinary calculi in pregnancy. Curr Opin Urol. 2001; 11: 379-384.

9. Masselli G, Brunelli R, Monti R, et al. Imaging for acute pelvic pain in pregnancy. Insights Imaging. 2014; 5: 165e81.

10. Semins MJ, Matlaga BR. Management of urolithiasis in pregnancy. Int J Womens Health. 2013; 5: 599e604.

11. Jandaghi AB, Falahatkar S, Alizadeh A, et al. Assessment of ureterovesical jet dynamics in obstructed ureter by urinary stone with color Doppler and duplex Doppler examinations. Urolithiasis. 2013; 41(2): 159e63.

12. Wachsberg RH. Unilateral absence of ureteral jets in the third trimester of pregnancy: pitfall in color Doppler US diagnosis of urinary obstruction. Radiology. 1998; 209: 279e81.

13. Shokeir AA, Mahran MR, Abdulmaaboud M. Renal colic in pregnant women: role of renal resistive index. Urology. 2000; 55: 344e7.

14. White WM, Johnson EB, Zite NB, et al. Predictive value of current imaging modalities for the detection of urolithiasis during pregnancy: a multicenter, longitudinal study. J Urol. 2013; 189: 931–934.

15. Masselli G, Derme M, Bernieri MG, et al. Stone disease in pregnancy: imaging‑guided therapy. Insights Imaging. 2014; 5: 691–696.

16. Semins MJ, Matlaga BR. Management of urolithiasis in pregnancy. Int J Womens Health. 2013; 5: 599–604.

17. Vidlář A. Diagnostika a léčba urolitiázy. Med. praxi. 2007; 4(12): 528–530.

18. American College of Obstetricians and Gynecologists’ – Committee on Obstetric Practice. Committee Opinion No. 723: guidelines for diagnostic imaging during pregnancy and lactation. Obstet Gynecol. 2017; 130(4): e210–e6.

19. Masselli G, Derchi L, McHugo J, et al. Acute abdominal and pelvic pain in pregnancy: ESUR recommendations. Eur Radiol. 2013; 23(12): 3485–500.

20. Austin LM, Frush DP. Compendium of national guidelines for imaging the pregnant patient. AJR Am J Roentgenol. 2011; 97: 737e46.

21. Smith’s Textbook of Endourology, Fourth Edition. Edited by Arthur D. Smith, Glenn M. Preminger, Louis R. Kavoussi, and Gopal H. Badlani. © 2019 John Wiley & Sons Ltd. Published 2019 by John Wiley & Sons Ltd, pp. 788.

22. Assimos D, Krambeck A, Miller NL, et al. Surgical management of stones: American Urological Association/ Endourological Society guideline, PART II. J Urol. 2016; 196: 1161–1169.

23. Turk CKT, Petrik A, Sarica K, et al (2021) EAU Guidelines on Urolithiasis. Uroweb 2021. http://www.uroweb. org/gls/pdf/22 Urolithiasis_LR.pdf.

24. Assimos D, Krambeck A, Miller NL, et al. Surgical management of stones: American Urological Association/ Endourological Society guideline, PART I. J Urol. 2016; 196: 1153–1160.

25. Choi CI, Yu YD and Park DS. Ureteral stent insertion in the management of renal colic during pregnancy. Chonnam Med J. 2016; 52: 123–127.

26. Ordon M, Dirk J, Slater J, et al. Incidence, Treatment, and Implications of Kidney Stones During Pregnancy: A Matched Population‑Based Cohort Study. J Endourol. 2020; 34(2): 215–21.

27. Jarrard DJ, Gerber GS. Management of acute ureteral obstruction in pregnancy utilizing ultrasound‑guided placement of ureteral stents. Urology. 1993; 42: 263–267.

28. Semins MJ, Trock BJ, Matlaga BR. The safety of ureteroscopy during pregnancy: a systematic review and meta‑analysis. J Urol. 2009; 181: 139–143.

29. Khoo L, Anson K, Patel U. Success and short‑term complication rates of percutaneous nephrostomy during pregnancy. J Vasc Interv Radiol. 2004; 15: 1469–1473.

30. Song Y, Xiang F, Yongsheng S. Diagnosis and operative intervention for problematic ureteral calculi during pregnancy. Int J Gynaecol Obstet. 2013; 121: 115–118.

31. Practice ACoO. ACOG Committee Opinion No. 474: nonobstetric surgery during pregnancy. Obstet Gynecol. 2011; 117(2 Pt 1): 420–421.

32. Deliveliotis CH, Argyropoulos B, Chrisofos M, Dimopoulos CA. Shockwave lithotripsy in unrecognized pregnancy: interruption or continuation? J Endourol. 2001; 15(8): 787–8.

33. Toth C, Toth G, Varga A, Flasko T, Salah MA. Percutaneous nephrolithotomy in early pregnancy. Int Urol Nephrol. 2005; 37(1): 1–3.

34. Laing KA, Lam TBL, Mcclinton S, et al. Outcomes of ureteroscopy for stone disease in pregnancy: Results from a systematic review of the literature. Urol Int. 2012; 89: 380–6. doi: 10.1159/000343732.

35. Zhang S, Liu G, Duo Y, et al. Application of ureteroscope in emergency treatment with persistent renal colic patients during pregnancy. PloS One. 2016; 11: e0146597. doi: 10.1371/journal.pone.0146597.

36. Buttice S, Lagana AS, Vitale SG, et al. Ureteroscopy in pregnant women with complicated colic pain: Is there any risk of premature labor? Arch Ital Urol Androl. 2017; 89: 287–92. doi: 10.4081/aiua.2017. 4. 287.

37. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240: 205–13.

38. Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery. 1992; 111: 518–26.

39. Sohlberg EM, Brubaker WD, Zhang CA, et al. Urinary Stone Disease in Pregnancy: A Claims Based Analysis of 1.4 Million Patients. J Urol. 2020; 203(5): 957–61.

40. Andreoiu M, MacMahon R. Renal colic in pregnancy: lithiasis or physiological hydronephrosis? Urology. 2009; 74(4): 757–61. doi: 10.1016/j.urology.2009. 03. 054. Epub 2009 Aug 5. PMID: 19660792.

Labels
Paediatric urologist Nephrology Urology
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#