Effectiveness and safety of ureteroscopy in pregnant women: a comparative study

The aim of this study was to investigate the efficacy and safety of ureteroscopy (URS) in pregnant patients compared with non-pregnant patients. We reviewed the cases of 41 pregnant and 62 non-pregnant women who developed ureteral stones and were treated with URS in our center between April 2005 and September 2011. A semi-rigid 9.5 F ureteroscope was used. The calculi were fragmented with pneumatic lithotripsy or a holmium laser, and if necessary, a double-J (JJ) stent was inserted during the procedure. Among the pregnant women, the mean gestation period was 23.22 +/- 4.61 weeks (range 13-34), and the mean number of pregnancies per patient was 3 +/- 2.02 (range 1-10). The mean ages of the pregnant and non-pregnant patients were 27.41 +/- 5.79 and 28.54 +/- 7.94 years, respectively (p = 0.734). There were no statistically significant differences in stone localization, anesthesia type, stone diameter, methods of stone manipulation, JJ stent insertion rate, hospitalization length, or operative times between the two groups. For pregnant and non-pregnant patients, the stone-free rates achieved in a single session were 87.8 and 85.5 %, respectively (p = 0.737). There was no statistically significant difference in preoperative and postoperative complication rates between the two groups. The positive urine culture rate was statistically significantly higher for pregnant patients than non-pregnant patients (29.3 vs. 11.3 %; p = 0.021). We did not observe any serious obstetric complications. URS is a safe and reasonable treatment option for pregnant patients with ureteral stones refractory to medical treatment during pregnancy.