Bayar Goksel, Bozkurt Yasar, Acinikli Huseyin, Dagguli Mansur, Cakmak Sedat, Nuri Bodakci Mehmet, Kemal Hatipoglu Namik, Tanriverdi Orhan
Department of Urology. Sisli Hamidiye Etfal Training and Research Hospital. Istanbul. Turkey.
Department of Urology. Dicle University Medicine Faculty. Diyarbakir. Turkey.
Arch Esp Urol. 2015 May;68(4):435-40.
We aimed to compare ureterolithotripsy and inserting only ureteral-j stent in terms of efficiency, safety and patient comfort in treatment of ureteral calculi in pregnant patients.
Seventy patients who developed hydronephrosis due to ureteral calculi during pregnancy, and on whom endoscopic intervention was performed were included in the study. In a center, the stones were broken up by ureteroscopy, and then ureteral stents (JJ) were placed if needed. In the other center, nothing was performed on the stones, and only ureteral stents (JJ) was placed. For the statistical analysis, Pearson's chi squared test and the Mann-Whitney U tests were used and the significance level was determined as p < 0.05.
The average age of the patients was 26.2 years (18-39) and the average gestational week was 23.4 weeks (8-36). While no significant difference was found between the two groups in terms of the frequency of complications (p=0.381) and post-operative pyelonephritis (p=0.2), the need for additional intervention in the group on whom ureteroscopy was performed was found to be less (9.7% vs. 31%; p=0.032). Moderate or severe LUTS or flank pain during the period between the procedure and the birth was found to be significantly less in the group in which ureterolithotripsy was performed (14% vs. 55%; p=0.036).
Ureterolithotripsy is a safe and more comfortable procedure than only ureteral double-j insertion on pregnant patients with ureterolithiasis.
我们旨在比较输尿管镜碎石术与单纯置入输尿管支架在治疗妊娠合并输尿管结石患者时的效率、安全性和患者舒适度。
纳入70例在孕期因输尿管结石导致肾积水且接受内镜干预的患者。在一个中心，通过输尿管镜碎石，然后根据需要置入输尿管支架（双J管）。在另一个中心，不对结石进行处理，仅置入输尿管支架（双J管）。统计分析采用Pearson卡方检验和Mann-Whitney U检验，显著性水平设定为p<0.05。
患者的平均年龄为26.2岁（18 - 39岁），平均孕周为23.4周（8 - 36周）。两组在并发症发生率（p = 0.381）和术后肾盂肾炎发生率（p = 0.2）方面无显著差异，但接受输尿管镜检查的组再次干预的需求较少（9.7%对31%；p = 0.032）。在接受输尿管镜碎石术的组中，术中至分娩期间中度或重度下尿路症状或胁腹疼痛明显较少（14%对55%；p = 0.036）。
对于妊娠合并输尿管结石的患者，输尿管镜碎石术比单纯置入输尿管双J管更安全、更舒适。
