Percutaneous nephrolithotomy in pregnancy: A comprehensive review and technical insights

IF 2.7 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology Pub Date : 2025-10-01 Epub Date: 2024-11-14 DOI:10.1016/j.ajur.2024.09.002

Daniel Pérez-Fentes , Esteban Emiliani , Ernesto Donoso , Alba García-Catalán , Lucía Mosquera-Seoane , Beatriz Ulloa-Iglesias , María E. Martínez-Corral

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引用次数: 0

Abstract

Objective

Urinary stones in pregnancy are usually managed conservatively or with temporary drainage, but in some cases, intervention is needed. Percutaneous nephrolithotomy (PCNL) is generally avoided due to its invasiveness and the requirement for fluoroscopy. This study aimed to review the literature on the use of PCNL in pregnancy, focusing on its safety, efficacy, feasibility, and technical aspects.

Methods

A narrative literature review was conducted using PubMed, Embase, and Scopus databases, covering the period from January 2000 to March 2024. The search terms included “percutaneous nephrolithotomy”, “PCNL”, “pregnancy”, and relevant variations thereof. The initial search retrieved 27 articles, of which only six studies involving 14 patients met the inclusion criteria.

Results

The reviewed studies included patients aged 23–34 years who underwent PCNL between 8 weeks and 28 weeks of gestation. Preoperative evaluations were exclusively based on ultrasound imaging, with stone sizes ranging from 8 mm to 48 mm. Indications for PCNL were persistent pain despite urinary diversion or reluctance to undergo stent replacement. Fluoroscopy was avoided in 13 patients. No maternal or fetal complications were reported.

Conclusion

PCNL appears to be a safe and feasible treatment option for selected cases of urinary stone disease during pregnancy. It should be performed in experienced centers, with proper patient counseling and a multidisciplinary approach to ensure the best outcomes.

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妊娠期经皮肾镜取石术：全面回顾和技术见解

目的妊娠期尿路结石通常采用保守治疗或临时引流，但在某些情况下，需要干预。经皮肾镜取石术（PCNL）由于其侵入性和需要透视，通常是避免的。本研究旨在综述PCNL在妊娠中的应用，重点讨论其安全性、有效性、可行性和技术方面的问题。方法采用PubMed、Embase和Scopus数据库对2000年1月至2024年3月的文献进行回顾性分析。检索词包括“经皮肾镜取石术”、“PCNL”、“妊娠”及其相关变体。最初的检索检索了27篇文章，其中只有6篇涉及14名患者的研究符合纳入标准。结果纳入的研究对象为年龄23-34岁，在妊娠8周至28周期间接受PCNL的患者。术前评估完全基于超声成像，结石大小从8毫米到48毫米不等。PCNL的适应症是持续疼痛，尽管尿转移或不愿接受支架更换。13例患者未行透视检查。未见母体或胎儿并发症的报道。结论pcnl是一种安全可行的治疗妊娠期尿路结石的方法。它应该在有经验的中心进行，适当的病人咨询和多学科的方法，以确保最好的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian Journal of Urology UROLOGY & NEPHROLOGY-

CiteScore

4.00

自引率

3.80%

发文量

100

审稿时长

4 weeks

期刊介绍： Asian Journal of Urology (AJUR), launched in October 2014, is an international peer-reviewed Open Access journal jointly founded by Shanghai Association for Science and Technology (SAST) and Second Military Medical University (SMMU). AJUR aims to build a communication platform for international researchers to effectively share scholarly achievements. It focuses on all specialties of urology both scientifically and clinically, with article types widely covering editorials, opinions, perspectives, reviews and mini-reviews, original articles, cases reports, rapid communications, and letters, etc. Fields of particular interest to the journal including, but not limited to: • Surgical oncology • Endourology • Calculi • Female urology • Erectile dysfunction • Infertility • Pediatric urology • Renal transplantation • Reconstructive surgery • Radiology • Pathology • Neurourology.