Shokeir A A, Mutabagani H
New Jeddah Clinic Hospital, Saudi Arabia.
Br J Urol. 1998 May;81(5):678-81. doi: 10.1046/j.1464-410x.1998.00626.x.
To report our experience with rigid ureteroscopy in pregnant women.
Ten pregnant women (mean age 25 years, SD 4.5, range 22-33) with ureteric stones were treated by ureteroscopy. The mean (SD, range) gestation time was 24 (6.5, 19-33) weeks. A standard rigid ureteroscope of 11.5 F was used in eight patients and 9.5 F in two. The procedure was carried out with no ureteric dilatation in three patients and with easy dilatation in seven. Fluoroscopy was not used before or during ureteroscopy in any case. Ultrasonography was available throughout the procedures for constant renal and obstetric monitoring.
Mid and lower ureteric stones were extracted by basket or forceps in three patients and had to be disintegrated by ultrasound in two. Upper ureteric stones were displaced to the kidney, with placement of double-pigtail ureteric stents, in three patients who were subsequently treated after delivery. Ureteric oedema was seen in one patient and the endoscopic findings were normal in the remaining patient. There were no obstetric complications. Two patients had a urinary tract infection and one complained of stent-induced bladder irritation.
Rigid ureteroscopy is a safe and reliable method in the diagnosis and treatment of ureteric calculi during pregnancy. The procedure can be performed with ultrasonographic monitoring and without using fluoroscopy.
报告我们在孕妇中进行硬性输尿管镜检查的经验。
10例输尿管结石孕妇（平均年龄25岁，标准差4.5，范围22 - 33岁）接受了输尿管镜检查。平均（标准差，范围）妊娠时间为24（6.5，19 - 33）周。8例患者使用11.5F的标准硬性输尿管镜，2例使用9.5F的。3例患者未进行输尿管扩张，7例患者进行了轻松扩张。在任何情况下，输尿管镜检查前或检查期间均未使用荧光透视。整个手术过程中均有超声检查以持续监测肾脏和产科情况。
3例患者通过网篮或镊子取出中下段输尿管结石，2例患者的结石需用超声碎石。3例上段输尿管结石患者结石移位至肾脏，放置了双猪尾输尿管支架，这些患者在产后接受了后续治疗。1例患者出现输尿管水肿，其余患者内镜检查结果正常。无产科并发症。2例患者发生尿路感染，1例患者抱怨支架引起膀胱刺激。
硬性输尿管镜检查是孕期诊断和治疗输尿管结石的一种安全可靠的方法。该手术可在超声监测下进行，无需使用荧光透视。
