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Rigid ureteroscopy for diagnosis and treatment of ureteral calculi during pregnancy.
MedLine Citation:
PMID:  15748336     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate ureteroscopy as a treatment option for women presenting ureteral calculi during pregnancy. MATERIALS AND METHODS: Eighteen pregnant patients presenting renal colic and indication of surgical treatment for ureteral calculi were analyzed. Patients were 20 to 34 years old (medium = 28), and the gestation period ranged from 12 to 34 weeks (medium = 18). Lumbar pain was present in 14 patients, and 4 had diffuse abdominal pain. Four patients were febrile in the occasion of the examination. Thirteen patients presented microscopic hematuria, 8 leucocituria, and 4 positive urine culture. The stone was detected by ultrasonography (US) in 12 patients. Magnetic resonance imaging (MRI) was performed in 2 cases, and did not demonstrate calculi. The stone location was: 1 in the superior ureter (pregnancy of 15 weeks), 4 in the medium ureter (pregnancy of 12, 15, 18 and 20 weeks), 12 in the inferior ureter, and 1 was not determined. The surgical indication was difficult pain control, fever, and presence of uterine contractions. RESULTS: Double-J insertion, as single treatment, was possible in 4 patients and it was kept in place for up to 2 weeks after delivery. Among the patients submitted to ureteroscopy, the calculi retrieval was always possible, except in 1 case where the calculus was not located by US, MRI or ureteroscopy. In 2 patients, the ultrasonic lithotriptor was used and in 11 the stone was removed intact with a basket. There were no complications due to the procedure and all pregnancies were carried to full term. CONCLUSION: Rigid ureteroscopy for extraction of ureteral calculi during pregnancy is efficient and safe.
Authors:
Gustavo C Lemos; Omar R El Hayek; Marcelo Apezzato
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International braz j urol : official journal of the Brazilian Society of Urology     Volume:  28     ISSN:  1677-5538     ISO Abbreviation:  Int Braz J Urol     Publication Date:    2002 Jul-Aug
Date Detail:
Created Date:  2005-03-07     Completed Date:  2005-04-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158091     Medline TA:  Int Braz J Urol     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  311-5; discussion 316     Citation Subset:  -    
Affiliation:
Albert Einstein Jewish Hospital, São Paulo, SP, Brazil. gclemos@ajato.com.br
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