Ureteroscopy for Urolithiasis in Pregnancy: Outcomes of a Multicentre Study on Behalf of the European Association of Urology Section of Endourology
Background and objective: In patients with stone disease during pregnancy, surgical management in the form of ureteroscopy (URS) can be indicated. However, there remains a relatively limited pool of published data. The objective was to perform a multicentre and international study evaluating the saf...
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Elsevier
2025-06-01
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| Series: | European Urology Open Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168325001247 |
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| author | Patrick Juliebø-Jones Vineet Gauhar Smita De Øyvind Ulvik Yiloren Tanidir Nebil Akdogan Cemil Aydin Pablo Contreras Maria Florencia Frascheri Javier Pizzarello Deepak Ragoori Lazaros Tzelves Peder Gjengstø Mathias Sørstrand Æsøy Albert El Hajj Elsayed Desouky Alejandro Bautista-Perez-Gavilan Vigen Malkhasyan Olivier Traxer Christian Beisland Bhaskar K. Somani |
| author_facet | Patrick Juliebø-Jones Vineet Gauhar Smita De Øyvind Ulvik Yiloren Tanidir Nebil Akdogan Cemil Aydin Pablo Contreras Maria Florencia Frascheri Javier Pizzarello Deepak Ragoori Lazaros Tzelves Peder Gjengstø Mathias Sørstrand Æsøy Albert El Hajj Elsayed Desouky Alejandro Bautista-Perez-Gavilan Vigen Malkhasyan Olivier Traxer Christian Beisland Bhaskar K. Somani |
| author_sort | Patrick Juliebø-Jones |
| collection | DOAJ |
| description | Background and objective: In patients with stone disease during pregnancy, surgical management in the form of ureteroscopy (URS) can be indicated. However, there remains a relatively limited pool of published data. The objective was to perform a multicentre and international study evaluating the safety and outcomes of URS in pregnancy. Methods: A retrospective study was performed across 12 tertiary endourology centres for patients undergoing URS during pregnancy over the past 10 yr. Data were collected on demographics, diagnostic imaging, operative findings, and intra- and postoperative complications. Follow-up data on stone-free rate (SFR) and pregnancy outcomes were also obtained. Key findings and limitations: A total of 146 females underwent URS, and the median age was 28 yr (interquartile range [IQR] 24–32). The majority were in the 2nd trimester (58%), were not presented (74%), and had the surgery performed by an endourologist (81%). Ultrasound was the most popular diagnostic imaging modality. Anaesthesia type was as follows: general (62%), spinal (23%), and sedation (15%). The negative URS rate was 48%. The median operative time was 35 min (IQR 35–45), and 77% were discharged within 24 h. The early and late complication rates were 11% and 2.8%, respectively. Regarding the former, there were two intensive care admissions (Clavien IV). In patients in whom a stone was found at URS, the SFR in terms of zero fragments was 65% and it was 78% for residual fragments of ≤2 mm based on postpartum imaging follow-up. Conclusions and clinical implications: In the setting of a tertiary centre, URS can be performed safely during pregnancy with a low risk of major complications. Future studies are needed to investigate how the diagnostic algorithm can be improved to result in a lower rate of negative URS. Patient summary: Managing kidney disease in pregnancy is recognised to be challenging as the surgeon must deliver safe care for both the mother and the unborn child. This is even more so the case when surgery to remove a stone is indicated. This study found that performing surgery using a method called ureteroscopy is safe, but it is recommended to be performed in an expert centre. |
| format | Article |
| id | doaj-art-12b4b9766b8e4a64bce8f68e61d4f976 |
| institution | DOAJ |
| issn | 2666-1683 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj-art-12b4b9766b8e4a64bce8f68e61d4f9762025-08-20T03:20:56ZengElsevierEuropean Urology Open Science2666-16832025-06-0176657010.1016/j.euros.2025.05.003Ureteroscopy for Urolithiasis in Pregnancy: Outcomes of a Multicentre Study on Behalf of the European Association of Urology Section of EndourologyPatrick Juliebø-Jones0Vineet Gauhar1Smita De2Øyvind Ulvik3Yiloren Tanidir4Nebil Akdogan5Cemil Aydin6Pablo Contreras7Maria Florencia Frascheri8Javier Pizzarello9Deepak Ragoori10Lazaros Tzelves11Peder Gjengstø12Mathias Sørstrand Æsøy13Albert El Hajj14Elsayed Desouky15Alejandro Bautista-Perez-Gavilan16Vigen Malkhasyan17Olivier Traxer18Christian Beisland19Bhaskar K. Somani20Department of Urology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway; Corresponding author. Department of Urology, Haukeland University Hospital, Bergen, Norway. Tel. +47 55 97 50 00.Department of Urology, Ng Teng Fong General Hospital, SingaporeDepartment of Urology, Cleveland Clinic Glickman Urological & Kidney Institute, Cleveland, OH, USADepartment of Urology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, NorwayDepartment of Urology, Medicana Atasehir Hospital, Istanbul, TurkeyDepartment of Urology, Faculty of Medicine, Çukurova University, Adana, TurkeyDepartment of Urology, Hitit University School of Medicine, Training and Research Hospital, Corum, TurkeyDepartment of Urology, Hospital Alemán de Buenos Aires, Buenos Aires, ArgentinaDepartment of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UKDepartment of Urology, Hospital Alemán de Buenos Aires, Buenos Aires, ArgentinaDepartment of Urology, Asian Institute of Nephrology and Urology, Hyderabad, IndiaDepartment of Urology, National and Kapodistrian University of Athens, Sismanogleio General Hospital, Athens, GreeceDepartment of Urology, Haukeland University Hospital, Bergen, NorwayDepartment of Urology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, NorwayDepartment of Urology, American University of Beirut Medical Center, Beirut, LebanonDepartment of Urology, Cleveland Clinic Glickman Urological & Kidney Institute, Cleveland, OH, USADepartment of Urology, Cleveland Clinic Glickman Urological & Kidney Institute, Cleveland, OH, USAEndourology Academy, Istanbul, TurkeyDepartment of Urology, Hôpital Tenon, Paris, FranceDepartment of Urology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, NorwayDepartment of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UKBackground and objective: In patients with stone disease during pregnancy, surgical management in the form of ureteroscopy (URS) can be indicated. However, there remains a relatively limited pool of published data. The objective was to perform a multicentre and international study evaluating the safety and outcomes of URS in pregnancy. Methods: A retrospective study was performed across 12 tertiary endourology centres for patients undergoing URS during pregnancy over the past 10 yr. Data were collected on demographics, diagnostic imaging, operative findings, and intra- and postoperative complications. Follow-up data on stone-free rate (SFR) and pregnancy outcomes were also obtained. Key findings and limitations: A total of 146 females underwent URS, and the median age was 28 yr (interquartile range [IQR] 24–32). The majority were in the 2nd trimester (58%), were not presented (74%), and had the surgery performed by an endourologist (81%). Ultrasound was the most popular diagnostic imaging modality. Anaesthesia type was as follows: general (62%), spinal (23%), and sedation (15%). The negative URS rate was 48%. The median operative time was 35 min (IQR 35–45), and 77% were discharged within 24 h. The early and late complication rates were 11% and 2.8%, respectively. Regarding the former, there were two intensive care admissions (Clavien IV). In patients in whom a stone was found at URS, the SFR in terms of zero fragments was 65% and it was 78% for residual fragments of ≤2 mm based on postpartum imaging follow-up. Conclusions and clinical implications: In the setting of a tertiary centre, URS can be performed safely during pregnancy with a low risk of major complications. Future studies are needed to investigate how the diagnostic algorithm can be improved to result in a lower rate of negative URS. Patient summary: Managing kidney disease in pregnancy is recognised to be challenging as the surgeon must deliver safe care for both the mother and the unborn child. This is even more so the case when surgery to remove a stone is indicated. This study found that performing surgery using a method called ureteroscopy is safe, but it is recommended to be performed in an expert centre.http://www.sciencedirect.com/science/article/pii/S2666168325001247UrolithiasisPregnancyUreteroscopySafety |
| spellingShingle | Patrick Juliebø-Jones Vineet Gauhar Smita De Øyvind Ulvik Yiloren Tanidir Nebil Akdogan Cemil Aydin Pablo Contreras Maria Florencia Frascheri Javier Pizzarello Deepak Ragoori Lazaros Tzelves Peder Gjengstø Mathias Sørstrand Æsøy Albert El Hajj Elsayed Desouky Alejandro Bautista-Perez-Gavilan Vigen Malkhasyan Olivier Traxer Christian Beisland Bhaskar K. Somani Ureteroscopy for Urolithiasis in Pregnancy: Outcomes of a Multicentre Study on Behalf of the European Association of Urology Section of Endourology European Urology Open Science Urolithiasis Pregnancy Ureteroscopy Safety |
| title | Ureteroscopy for Urolithiasis in Pregnancy: Outcomes of a Multicentre Study on Behalf of the European Association of Urology Section of Endourology |
| title_full | Ureteroscopy for Urolithiasis in Pregnancy: Outcomes of a Multicentre Study on Behalf of the European Association of Urology Section of Endourology |
| title_fullStr | Ureteroscopy for Urolithiasis in Pregnancy: Outcomes of a Multicentre Study on Behalf of the European Association of Urology Section of Endourology |
| title_full_unstemmed | Ureteroscopy for Urolithiasis in Pregnancy: Outcomes of a Multicentre Study on Behalf of the European Association of Urology Section of Endourology |
| title_short | Ureteroscopy for Urolithiasis in Pregnancy: Outcomes of a Multicentre Study on Behalf of the European Association of Urology Section of Endourology |
| title_sort | ureteroscopy for urolithiasis in pregnancy outcomes of a multicentre study on behalf of the european association of urology section of endourology |
| topic | Urolithiasis Pregnancy Ureteroscopy Safety |
| url | http://www.sciencedirect.com/science/article/pii/S2666168325001247 |
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