MP31-02 MEDICAL EXPULSIVE THERAPY IN PREGNANCY; A RETROSPECTIVE STUDY.

Abstract

You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy II1 Apr 2018MP31-02 MEDICAL EXPULSIVE THERAPY IN PREGNANCY; A RETROSPECTIVE STUDY. Benoit Theriault, Fannie Morin, and Jonathan Cloutier Benoit TheriaultBenoit Theriault More articles by this author , Fannie MorinFannie Morin More articles by this author , and Jonathan CloutierJonathan Cloutier More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1031AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Background: The use of medical expulsive therapy (MET) is common practice in urology for the treatment of symptomatic urolithiasis, despite its efficacy is debated. Its use in pregnancy is even more controversial because of poor safety data. Objective: To evaluate the safety and efficacy of tamsulosin 0,4 mg once a day as a MET in pregnant women. METHODS We retrospectively identified pregnant patients who presented with renal colic at the CHU de Québec from 2000 to 2015. We compared patients who received tamsulosin as MET to a control group without MET. We evaluated efficacy as passage rate of lithiasis and necessity of intervention or additional treatment. We evaluated safety of the treatment according to fetal outcomes (fetal weight at birth, APGAR, gestational age, etc.) Groups were compared using linear regression models for continuous variables and logistic regression models for nominal variables, using the SAS software, version 9.4. RESULTS We evaluated 207 pregnant patients presenting renal colic, 69 patients in the MET group were compared to 138 patients in the control group. Of these, 48 (70%) in the tamsulosin therapy group and 76 (55%) in the control group had proven urolithiasis. Every exposition to tamsulosin occurred in the second (46%) and third (54%) trimester. No significant difference was found for mean gestational age, birthweight at term and APGAR. No sudden death infant syndrome was encountered in neither group. There was no significant difference for length of hospitalisation stay, and need for surgical intervention. The spontaneous passage rate was 52% (25/48) in the MET group compared to 38% (29/76), but this difference was not statistically significant (p= 0,13). Tamsulosin therapy was associated with longer time to spontaneous passage (mean 34 vs 17 days, p = 0,01). CONCLUSIONS Short-term utilisation of tamsulosin as MET in pregnancy is not associated with adverse maternal or infant outcomes. Moreover, there was no significant adjunct for the rate of stone passage. Conservative management of renal colic in pregnancy remains a safe treatment option. Further studies are needed in the evaluation of MET as adjunctive therapy for symptomatic urolithiasis during pregnancy. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e411 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Benoit Theriault More articles by this author Fannie Morin More articles by this author Jonathan Cloutier More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...