Keshvari Shirvan Maliheh, Darabi Mahboub Mohammad Reza, Rahimi Hamid Reza, Seyedi Ali
Department of Urology, Imam Reza Academic Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Nephrourol Mon. 2013 Sep;5(4):874-8. doi: 10.5812/numonthly.10726. Epub 2013 Aug 12.
Urinary stone incidence in pregnancy has been reported in a wide range, from 1 in 200 to 1 in 2000 cases.
The aim of this study was to investigate the efficacy and safety of ureteroscopic treatment and its results and complications for pregnant women with urinary stones.
From 2003 till 2011, 113 pregnant patients with symptomatic urolithiasis were admitted to the urology emergency clinic at Imam Reza hospital. All patients were initially treated conservatively, resulting in spontaneous passage of the calculi in 69 patients. Forty-four patients with symptomatic urolithiasis were included in the study. Post-operative follow ups, including maternal and fetal health was performed by a gynecologist consult fetal heart rate assessment and urine analysis and culture and renal and urethral ultrasonography.
The mean age of the patients was 23 years ± 2 (19-34) and the mean gestational age was 24 ± 3 weeks. The overall and pneumatic lithotripsy success rate was 100%. All patients from the interventional group delivered at term with no fetal or maternal complications. There was no morbidity during and after the operation.
In conditions, medical management of urinary stones and consequent renal colic in pregnant women cannot improve patients' symptoms, choosing of a surgical method like setting of a DJ catheter or URS and pneumatic lithotripsy can be a safe and effective way for the health of both the mother and fetus. Of course, more research is needed to establish this approach as the standard method in pregnancy urinary stones.
妊娠期间尿路结石的发病率报道范围很广,从200例中有1例到2000例中有1例。
本研究的目的是调查输尿管镜治疗对妊娠合并尿路结石患者的有效性、安全性及其结果和并发症。
2003年至2011年,113例有症状的妊娠尿路结石患者入住伊玛目礼萨医院泌尿外科急诊诊所。所有患者最初均接受保守治疗,69例患者结石自行排出。44例有症状的尿路结石患者纳入研究。术后随访包括由妇科医生进行母婴健康检查、胎儿心率评估、尿液分析与培养以及肾脏和尿道超声检查。
患者的平均年龄为23岁±2岁(19 - 34岁),平均孕周为24±3周。总体气压弹道碎石成功率为100%。干预组所有患者均足月分娩,无母婴并发症。手术期间及术后均无发病情况。
在某些情况下,对妊娠合并尿路结石及由此导致的肾绞痛进行药物治疗无法改善患者症状,选择诸如放置DJ导管或输尿管镜检查及气压弹道碎石等手术方法对母婴健康而言可能是一种安全有效的方式。当然,需要更多研究将这种方法确立为妊娠尿路结石的标准治疗方法。