Double-J ureteric stenting in pregnancy: A single-centre experience from Iraq

Ngai, Ho‐Yin; Salih, Hawre Qadir; Albeer, Ayad; Aghaways, Ismaeel; Buchholz, Noor

doi:10.1016/j.aju.2013.02.002

Cited by 19 publications

(18 citation statements)

References 16 publications

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“…Stent placement may have complications, such as catheter migration, stent irritation, stent encrustation, hematuria, ascending pyelonephritis caused by vesico-uretheral reflux, or stone formation. [24][25][26][27][28] The overall complication rate of JJ ureteric stenting, i.e. stent migration, LUTS, and hematuria, was found to be 18% in this study, which is consistent with other series (6-37%).…”

Section: Discussionsupporting

confidence: 90%

Ureteral stent insertion in pregnants with intractable flank pain: A clinical experience

Can¹

2018

South Clin Ist Euras

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Objective: The aim of this study was to evaluate the efficacy of JJ stent placement in pregnant patients with persistent flank pain. Methods:The records of pregnant women with flank pain who presented between January 2011 and March 2016 were retrospectively reviewed. Patients who did not respond to initial conservative treatments and were hospitalized were enrolled in the study. Demographic data, clinical and laboratory findings, and surgical interventions, such as JJ stenting or percutaneous nephrostomy, as well as any complications were all recorded and evaluated.Results: Forty-one pregnant women were included in the study. No surgical intervention was required in 7 (17%) cases after secondary conservative management, while 34 patients with persistent flank pain required JJ stenting/nephrostomy. The mean duration of hospitalization was 2.9±2.7 days. Complications of migration (n=3), lower urinary tract symptoms (n=1), and hematuria (n=2) were observed in the patients who had a stent inserted. Postpartum imaging (abdominal computed tomography scan) indicated that 5 (15%) of 32 patients required additional stone surgery.Conclusion: Urgent JJ stent placement was found to be effective and safe and have a low complication rate in the management of pregnant women with persistent flank pain.

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Section: Discussionsupporting

confidence: 90%

Ureteral stent insertion in pregnants with intractable flank pain: A clinical experience

Can¹

2018

South Clin Ist Euras

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“…93,94 The use of MET for pregnant patients as "offlabel" use remains debatable. 94 When clinical indications for intervention emerges, placement of a ureteral stent or percutaneous nephrostomy tube is an effective option; 94,215,216 however, URS has been identified as a reasonable alternative in these situations. [217][218][219] SWL is an absolute contraindication, and PCNL should be generally avoided.…”

Section: Commentarymentioning

confidence: 99%

The Urological Association of Asia clinical guideline for urinary stone disease

et al. 2019

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The Urological Association of Asia, consisting of 25 member associations and one affiliated member since its foundation in 1990, has planned to develop Asian guidelines for all urological fields. The field of stone diseases is the third of its guideline projects. Because of the different climates, and social, economic and ethnic environments, the clinical practice for urinary stone diseases widely varies among the Asian countries. The committee members of the Urological Association of Asia on the clinical guidelines for urinary stone disease carried out a surveillance study to better understand the diversity of the treatment strategy among different regions and subsequent systematic literature review through PubMed and MEDLINE database between 1966 and 2017. Levels of evidence and grades of recommendation for each management were decided according to the relevant strategy. Each clinical question and answer were thoroughly reviewed and discussed by all committee members and their colleagues, with suggestions from expert representatives of the American Urological Association and European Association of Urology. However, we focused on the pragmatic care of patients and our own evidence throughout Asia, which included recent surgical trends, such as miniaturized percutaneous nephrolithotomy and endoscopic combined intrarenal surgery. This guideline covers all fields of stone diseases, from etiology to recurrence prevention. Here, we present a short summary of the first version of the guideline – consisting 43 clinical questions – and overview its key practical issues.

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“…Common information of publications was showed in Table 1 . Briefly, among these studies, 1 from Norway[8], 1 from Italy[9], 2 from America[10], 1 from Brazil[11], 1 from Pakistan[12], 4 from Egypt[13, 20, 27, 29], 5 from China[14, 22, 28, 30, 32], 6 from Turkey[15-18, 21, 25], 2 from Iran[23, 31], 1 from Iraq[24] and 1 from Romania[26]. The age range was from 16 to 41, and urolithiasis occurred in the second trimester most.…”

Section: Resultsmentioning

confidence: 99%

“…Historically, serial stenting was considered as the gold standard surgical treatment for pregnancy with urolithiasis as it was less invasive and could be performed under local anesthesia [40]. This amount of anesthetic drugs and fewer surgical traumas was safer for the fetus [24]. And its effect of relieving obstruction and pain, maintenance of pregnancy was proved as this meta-analysis suggested.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of ureteroscopy and internal ureteral stent for pregnancy with urolithiasis: a systematic review and meta-analysis

Jin

Liu

Xiong³

et al. 2020

Preprint

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Objectives To investigate the outcomes of internal ureteral stent versus ureteroscopy (URS) treatments for pregnant women with urolithiasis. Design This is a systematic review and meta-analysis of observational studies that investigated the outcomes of internal ureteral stent and ureteroscopy for pregnancy with urolithiasis. This systematic review have been registered on the PROSPERO website (www.york.ac.uk/inst/crd, registration number: CRD42020195607). Data Sources Relevant studies published from January 1980 to April 2020 were identified through a systematic literature search in MEDLINE, EMBASE, Web of Science and the Cochrane Library. Data extraction and synthesis All pregnant women in their all pregnancy stages who were underwent double-J (D-J) stent insertion only or URS operation for lithotripsy/stone extraction/exploration were considered. The number of related participants in study more than 10 were included. Fertility outcome and complications of intervention were extracted as main outcomes, while other data such as operation success rate, stone free rate (SFR), patient characteristics, anaesthetic method, ureteral stone characteristics, detail of interventions were obtained as well. Complications were stratified according to Clavien-Dindo criteria. Two authors independently extracted data and assessed the quality of included studies. Study-specific prevalence rates were pooled using a random-effects model. We applied the Newcastle-Ottawa Scale quality assessment to evaluate the quality of the selected studies. Results A total of 25 studies were identified with 131 cases undergoing serial stenting and 789 cases undergoing URS operation. The age range was from 16 to 41, and urolithiasis occurred in the second trimester most. Ultrasound was the most commonly used diagnostic method. The most common site of calculi was distal ureter. The average stone size was between 6-17mm. There were 6 studies investigating D-J stent insertion only, while 23 studies involving URS operation. The most commonly used anesthesia for internal ureteral stent therapy was local anesthesia, and for URS treatments, general anesthesia and spinal anesthesia were widely used. The pooled operation success rate was 97% for D-J stent insertion, and 99% for URS. Serial D-J stenting was an effective methods for treating ureter obstruction and only a few patients passed stone spontaneously. Different common lithotripters were used in URS operations and the pooled SFR was about 91%. For internal ureteral stent therapy; the rate of normal fertility outcome was 99%, but the pooled incidence of complications was about 45%. For the URS treatment group, the rate of normal fertility outcome was 99% as well, and the pooled incidence of complications was about 1%. However, the pooled premature and abortion incidence rate of two group were the same as less than 1%, and the same as this in serious complication incidence rate. Conclusions Both ureteroscopy operation and internal ureteral stent were usually used for handing pregnancy with urolithiasis. Two treatments had less side effective on fertility outcome, but internal ureteral stent may cause more complications. Evidence suggests that URS therapy may have a greater advantage for pregnancy with urolithiasis when the conditions permit. As it is proved safe and effective, internal ureteral stent could be considered at emergency condition or preoperative preparations was lack.

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Double-J ureteric stenting in pregnancy: A single-centre experience from Iraq

Cited by 19 publications

References 16 publications

Ureteral stent insertion in pregnants with intractable flank pain: A clinical experience

Ureteral stent insertion in pregnants with intractable flank pain: A clinical experience

The Urological Association of Asia clinical guideline for urinary stone disease

Outcomes of ureteroscopy and internal ureteral stent for pregnancy with urolithiasis: a systematic review and meta-analysis

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