Review on diagnosis and management of urolithiasis in pregnancy: an ESUT practical guide for urologists

Somani, Bhaskar K.; Dellis, Athanasios; Liatsikos, E.; Skolarikos, Andreas

doi:10.1007/s00345-017-2037-1

Cited by 49 publications

(48 citation statements)

References 86 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For the diagnosis of urinary stones in pregnant patients, major concerns are the effects of radiation exposure . Table shows the radiation doses absorbed by a fetus after common imaging modalities .…”

Section: Clinical Questions and Answersmentioning

confidence: 99%

“…Table shows the radiation doses absorbed by a fetus after common imaging modalities . The physician has to justify the need for any investigation resulting in an absorbed dose to the fetus of >0.5 mGy …”

Section: Clinical Questions and Answersmentioning

confidence: 99%

“…Transvaginal US has also been shown to improve sensitivity in the diagnosis of distal ureteral stones . MRI is used as a second‐line procedure, to differentiate physiological from obstructive hydronephrosis during pregnancy …”

Section: Clinical Questions and Answersmentioning

confidence: 99%

“…NSAIDs are contraindicated in pregnancy. Frequent small doses of morphine can be used safely for severe pain, and acetaminophen for mild analgesia . The use of MET for pregnant patients as “off‐label” use remains debatable .…”

Section: Clinical Questions and Answersmentioning

confidence: 99%

“…When clinical indications for intervention emerges, placement of a ureteral stent or percutaneous nephrostomy tube is an effective option; however, URS has been identified as a reasonable alternative in these situations . SWL is an absolute contraindication, and PCNL should be generally avoided …”

Section: Clinical Questions and Answersmentioning

confidence: 99%

See 4 more Smart Citations

The Urological Association of Asia clinical guideline for urinary stone disease

et al. 2019

View full text Add to dashboard Cite

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.

show abstract

Section: Clinical Questions and Answersmentioning

confidence: 99%

Section: Clinical Questions and Answersmentioning

confidence: 99%

Section: Clinical Questions and Answersmentioning

confidence: 99%

Section: Clinical Questions and Answersmentioning

confidence: 99%

Section: Clinical Questions and Answersmentioning

confidence: 99%

See 3 more Smart Citations

The Urological Association of Asia clinical guideline for urinary stone disease

et al. 2019

View full text Add to dashboard Cite

show abstract

Establishment of a diagnostic model for urinary calculi in pregnant women: A retrospective cohort study

Sun,

Xu,

et al. 2024

Intl J Gynecology & Obste

View full text Add to dashboard Cite

ObjectiveThe diagnosis of symptomatic urinary stones during pregnancy is challenging; ultrasonography has a low specificity and sensitivity for diagnosing urinary stones. This study aimed to develop a clinical diagnostic model to assist clinicians in distinguishing symptomatic urinary stones in pregnant women.MethodsIn this retrospective cohort study, we consecutively collected clinical data from pregnant women who presented with acute abdominal, lumbar, and lumbar and abdominal pain at the emergency department of our hospital between January 1, 2017, and December 31, 2019. To distinguish patients with urinary calculi from those without, we reviewed the follow‐up records within 2 weeks post‐consultation, ultrasonography results within 2 weeks, or self‐reports of stone passage within 2 weeks. We selected risk factors from the baseline clinical and laboratory data of patients to establish a diagnostic model.ResultsOf the total patients included in the study, 105 patients were diagnosed as having symptomatic urinary stones and 126 were determined to have abdominal pain for reasons other than urinary stones. The initial model had an area under the curve (AUC) of 0.9966. The No‐Lab Model had an AUC of 0.9856. The Lab Model had an AUC of 0.832. The Stone Model had an AUC of 0.9952. The simplified Stone Model did not show a decrease in discriminative ability.ConclusionOf the four diagnostic models that we established for preliminary diagnosis of symptomatic urinary tract stones in pregnant women, the simplified Stone Model demonstrated excellent performance. Users can scan quick response codes to access web‐based diagnostic model interfaces, facilitating easy clinical operation.

show abstract

Ureter Visualization With Transvaginal Ultrasound

Ong

Leonardi

Espada

et al. 2020

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objectives-To evaluate the learning curve of gynecologic surgical fellows (ie, in training) to properly identify the ureters in real time while simultaneously performing and interpreting transvaginal ultrasound (TVUS) examinations. Methods-We performed a prospective study, which took place at 2 centers in Sydney, Australia, from December 2017 to December 2018. Three fellows (F1-F3), of varying prestudy ultrasound (US) experience, were recruited to participate. One hundred fifty predetermined examinations were planned. A TVUS examination was performed by the study reference standard (an expert in gynecologic US). Subsequently, the fellows performed a focused component to identify bilateral ureters, having been blinded to the patient's clinical history and reference standard findings. Immediate feedback and hands-on teaching were provided after each of the fellow's evaluations were complete. To evaluate the number of scans needed to gain competency, the cumulative summation test for the learning curve was used. Results-A total of 150 examinations were performed on 145 patients. One patient had a single ureter, and 1 patient had US evidence of hydroureter. The cumulative summation test for the learning curve for bilateral ureter identification showed that F1 did not reach competency by 50 TVUS examinations, whereas F2 and F3 required 41 and 31 TVUS examinations to reach competency, respectively. Conclusions-Contrary to other studies on the topic, this study suggests that although it is feasible for surgical fellows to learn TVUS identification of bilateral ureters, not all fellows can reach competency during a program based on a predefined number of scans. We advocate for an individualized, competencybased medical education model in learning US for identifying the ureters.

show abstract

Review on diagnosis and management of urolithiasis in pregnancy: an ESUT practical guide for urologists

Abstract: Urolithiasis in pregnancy needs a careful multidisciplinary management to achieve good outcomes for both mother and baby. Our review shows that a balanced approach for diagnosis and treatment seems to achieve the best outcomes in pregnancy.

Cited by 49 publications

References 86 publications

The Urological Association of Asia clinical guideline for urinary stone disease

The Urological Association of Asia clinical guideline for urinary stone disease

Establishment of a diagnostic model for urinary calculi in pregnant women: A retrospective cohort study

Ureter Visualization With Transvaginal Ultrasound

Contact Info

Product

Resources

About