The Safety Of Ureteroscopy During Pregnancy: A Systematic Review And Meta-Analysis

Main Category: Pregnancy / Obstetrics
Also Included In: Urology / Nephrology
Article Date: 15 Feb 2009 - 2:00 PDT

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UroToday.com - Urolithiasis during pregnancy is one of the more vexing problems urologists encounter.

The Johns Hopkins group performed a literature review and meta-analysis of the safety of ureteroscopy (URS) and stone removal during pregnancy. They stratified the severity of the complications using the Clavien criteria which is helpful in assessing the significance of these complications. They assessed 14 reports with 108 patients and found an overall low rate of complications (8.3%). None of these complications were life-threatening and only 1 of 108 (0.9%) required endoscopic intervention, and this was a ureteral perforation requiring a stent. The other 8 complications were post-operative pain requiring analgesia (1.9%), urinary tract infection requiring antibiotic therapy (4.6%), or preterm uterine contraction requiring tocolytic agents (0.9%).

The types of complications and the complication rates appear to be similar to non-pregnant women undergoing ureteroscopy for urolithiasis. This is another piece of evidence-based medicine supporting ureteroscopic stone removal as first line therapy in pregnant patients.

Written by UroToday.com Contributing Editor Elspeth M. McDougall, MD, FRCSC, MHPE

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