E31 Outcomes of ureteroscopy for stone disease in pregnancy: Results from a systematic review of the literature

Abstract

Introduction: Our aim was to evaluate the clinical efficacy and safety of ureteroscopy as a primary treatment for preg- nant women with symptomatic ureteric stones who have failed conservative management. Materials and Methods: A systematic review of the literature from January 1990 to June 2011 was performed, including all English language ar- ticles. Outcome measures were clinical efficacy, in terms of stone clearance and need for additional procedures, and safety in terms of complications. Results: A total of 239 ab- stracts were screened and 15 studies were identified report- ing on 116 procedures. The surgical methods of stone man- agement employed were stone extraction with basket only (n = 55, 47%), laser fragmentation (n = 27, 23%; holmium, n = 20, pulse dye, n = 7), impact lithotripsy (n = 21, 18%), uretero- scopic lithotripsy (n = 6, 5%) and a combination of methods (n = 6, 5%). A post-operative stent was inserted in 64 of 116 procedures (55%). Complete stone clearance was seen in 100 of the 116 procedures (86%). There were 2 major complica- tions (1 ureteral perforation and 1 case of premature uterine contraction) and 7 minor complications (5 urinary tract infec- tions and 2 cases of post-operative pain). Conclusion: This review suggests that stone clearance using ureteroscopy is a relatively safe option in pregnancy with a high success rate.