Percutaneous Nephrolithotomy in Late Pregnancy

Abstract

The authors removed two pyeloureteric junction stones percutaneously in the 36th and 38th weeks of pregnancy because of complete obstruction and unrelenting spasm. Stone removal was considered to be far more advantageous than percutaneous nephrostomy alone in these cases. With the necessary skill and carefulness, the intervention is not dangerous for the fetus. The patients were placed in the semioblique prone position with the table raised under the arch of the ribs, and a thick hard cushion was placed under the pelvis on the side of the stone. A lead apron was placed under the fetus to reduce X-ray scatter, and the puncture was made under ultrasound guidance. Fetal X-ray exposure thus was negligible. The women gave birth to baby girls 3 and 5 weeks after percutaneous stone extraction. Both of them believed it far more advantageous not to keep a nephrostomy drain for many weeks.