MP16-13 CYSTINURIA AND PREGNANCY: CLINICAL COURSE AND OUTCOMES FROM 2000-2020

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP16-13 CYSTINURIA AND PREGNANCY: CLINICAL COURSE AND OUTCOMES FROM 2000-2020 Amy Reed and Nicole Miller Amy ReedAmy Reed More articles by this author and Nicole MillerNicole Miller More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003236.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Cystinuria is a rare disease which limits the understanding of its impact on pregnancy. We sought to characterize stone disease and management of patients with cystinuria during pregnancy at a single institution. METHODS: We completed a retrospective chart review of cystinuria patients at a single institution from 2000-2022. Patients were identified by ICD-10 codes (E72.01) and then included for childbearing potential. Charts were reviewed for urologic history as well as baseline medical and surgical treatment history. We evaluated imaging studies, stone episodes, stone surgeries and complications during pregnancy. This was then compared to the reported historic incidence of renal colic, stone diagnosis and surgical intervention during pregnancy. RESULTS: 44 female patients with cystinuria were identified and 40 were included based on child bearing potential. Patient age ranged from 16-68 years. Nine patients had a total of 27 pregnancies and 20 successful live births. Patients were treated with Thiola (3), urinary alkalinization (4) or fluid alone (5) and all medications were discontinued during pregnancy. Patients had an average of 6 stone surgeries prior to pregnancy. Comorbidities included chronic pain (2), chronic kidney disease (1) and multiple sclerosis (1). Renal colic occurred in 27% of pregnancies requiring an average of 1 renal ultrasound in addition to routine prenatal assessment. Of these, only one patient had confirmed stone events in 2 out of her 4 pregnancies (8.3% of symptomatic patients) which required a total of six surgeries (stent placement, ureteroscopy). The remaining 8 patients did not have any confirmed stone events. Comparatively, the reported incidence of renal colic in all pregnancies is 0.12% with 71% of these patients having confirmed stone events and 28% of them undergoing surgical intervention. Comparing pre- and post-partum imaging, 4 patients had radiographic evidence of stone growth during pregnancy. Pregnancies were complicated by 4 (15%) spontaneous abortions in the first trimester and one patient developed a ureteral stricture after ureteroscopy during pregnancy that required delayed reconstruction. CONCLUSIONS: Patients with cystinuria are at an increased risk of renal colic episodes during pregnancy but these symptomatic patients do not have a higher rate of stone diagnosis or surgical intervention. Cystinuria patients do not seem to increased complications during pregnancy. However, given a high rate of new stone formation, close follow up of these patients in the post-partum period is necessary. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e207 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Amy Reed More articles by this author Nicole Miller More articles by this author Expand All Advertisement PDF downloadLoading ...