Document Detail


Ureteroscopy and holmium:YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy.
MedLine Citation:
PMID:  12350466     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To review the results of holmium laser lithotripsy in a cohort of patients who presented with symptomatic urolithiasis in pregnancy. Symptomatic urolithiasis in pregnancy that does not respond to conservative measures has traditionally been managed with ureteral stent insertion or percutaneous nephrostomy. Holmium:yttrium-aluminum-garnet (YAG) laser lithotripsy using state-of-the-art ureteroscopes represents an emerging strategy for definitive stone management in pregnancy. METHODS: A retrospective analysis was conducted at two tertiary stone centers from January 1996 to August 2001 to identify pregnant patients who were treated with ureteroscopic holmium laser lithotripsy for symptomatic urolithiasis or encrusted stents. Eight patients with a total of 10 symptomatic ureteral calculi and two encrusted ureteral stents were treated. The mean gestational age at presentation was 22 weeks. The mean stone size was 8.1 mm. The stones were located in the proximal ureter/ureteropelvic junction (n = 3), midureter (n = 1), and distal ureter (n = 6). RESULTS: Complete stone fragmentation and/or removal of encrusted ureteral stents were achieved in all patients using the holmium:YAG laser. The overall procedural success rate was 91%. The overall stone-free rate was 89%. No obstetric or urologic complications were encountered. CONCLUSIONS: Ureteroscopy and holmium laser lithotripsy can be performed safely in all stages of pregnancy, providing definitive management of symptomatic ureteral calculi. The procedure can be done with minimal or no fluoroscopy and avoids the undesirable features of stents or nephrostomy tubes.
Authors:
James D Watterson; Andrew R Girvan; Darren T Beiko; Linda Nott; Timothy A Wollin; Hassan Razvi; John D Denstedt
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Urology     Volume:  60     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-27     Completed Date:  2002-11-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  383-7     Citation Subset:  IM    
Affiliation:
Division of Urology, University of Western Ontario, London, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Fluoroscopy / methods
Gestational Age
Holmium
Humans
Lithotripsy, Laser / methods*
Pregnancy
Pregnancy Complications / etiology,  therapy*,  ultrasonography
Retrospective Studies
Stents / adverse effects
Treatment Outcome
Ureteral Calculi / etiology,  therapy*,  ultrasonography
Ureteroscopy / methods*
Chemical
Reg. No./Substance:
7440-60-0/Holmium
Comments/Corrections
Comment In:
J Urol. 2003 Aug;170(2 Pt 1):688   [PMID:  14601594 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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