![]() Temporizing therapies and URSL were required in 12 of 36 (33.4%) patients. Conservative management was successful in 24 of 36 (66.6%) the patients. In the other 11 (30.6%) of the patients, definitive diagnosis was done by ureteroscopy in 5, and 6 of them passed their stones spontaneously. In 25 (69.4%) of the patients, ureteric stones was diagnosed on US. When conservative treatment failed, temporizing therapies (double-J stenting or percutaneous nephrostomy ) and (ureteroscopic lithotripsy) URSL were performed on the patients. Initially, conservative management was performed on all patients. The diagnosis was done by history, physical examination, symptoms, signs, ultrasonography, or ureteroscopy if needed. Thirty-six pregnant women with symptomatic ureteric stones were evaluated in this study. ![]() To present our experience to describe diagnosis and management of symptomatic ureteric stones during pregnancy. Semirigid ureteroscopy for diagnosing and treating ureteral calculi by intracorporeal pneumatic or holmium laser lithotripsy is a safe and reasonable treatment option for pregnant patients. ![]() In one patient, sepsis developed postoperatively, and improved with appropriate treatment. There was no serious complication intraoperatively, while urinary tract infection developed in four and renal colic in two patients postoperatively. Of the 32 patients, 19 (59.4%) required JJ stent insertion peroperatively. The stones were fragmented with pneumatic lithotripsy in 8 patients and with holmium laser in 17 patients and the fragments were retracted with forceps. Ureteric stones were found in 27 (84.3%) patients during endoscopy, 10 being distal, 9 middle and 8 proximal. Spinal anaesthesia was performed in 22 (68.8%) patients, while general anaesthesia was performed in 7 (21.8%) patients. The ultrasound findings were diagnostic of obstructive ureteral calculi in 16 (50%) patients and the mean stone diameter was 8 mm. The mean age of patients was 27.8 years (range 20-39), and the mean gestation duration was 24 weeks (15-34). A semirigid URS of 9.5 F was used in all patients. A retrospective analysis was performed on 32 pregnant patients referred to our center between April 2005 and November 2010 with hydronephrosis requiring surgical intervention. The aim of this study was to investigate the efficacy and safety of ureteroscopy (URS) in pregnant women. Ultimately, a multidisciplinary, team-based approach involving the patient, her obstetrician, urologist, radiologist, and anesthesiologist is needed to devise a maximally beneficial management plan. While temporizing treatments have classically been deemed the gold standard, ureteroscopic stone removal is now acknowledged as a safe and highly effective definitive treatment approach. In patients who fail spontaneous stone passage, treatment may be temporizing or definitive. ![]() A trial of conservative management is uniformly recommended. Ultrasound remains the first-line diagnostic imaging modality in this group, but other options are available if results are inconclusive. Diagnosis is further complicated by the need for careful selection of imaging modality in order to maximize diagnostic utility and minimize obstetric risk to the mother and ionizing radiation exposure to the fetus. The physiologic changes of pregnancy render the physical exam and imaging studies less reliable than in the typical patient. The experience can provoke undue stress for the mother, fetus, and management team. Urolithiasis is the most common nonobstetric complication in the gravid patient.
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