Ces Urol 2022, 26(2):90-98 | DOI: 10.48095/cccu2022014

Urolithiasis in pregnancy

Jan Vlnieška, Aleš Petřík

Urologické oddělení Nemocnice České Budějovice, a. s., České Budějovice

Vlnieška J. Petřík A. Urolithiasis in pregnancy. Renal colic is the most common non obstetric cause of hospital admission in pregnancy. Ideal managementof urinary stones which ensure the good condition of the mother and fetus is a challenge to urologists and gynecologists. There are several anatomical and functional changes in the urogenital tract of pregnant women, which lead to calculi formation. The most common symptom of ureteral stone is flank pain with microscopic or macroscopic hematuria. Inonizing imaging modalities should be avoided if is possible in pregnant women. Ultrasound is the first line imaging of choice. It is non invasive, low cost and generally available. Upper urinary tract dilatation can be reliably detected with ultrasound. MRI can be used to detect ureteral stones not seen on ultrasound. When MRI is not available, low dose CT seems to be safe option, but only as last resort when imaging before endoscopic intevention is required by the treating urologist. Conservative managment, with observation and waiting for spontaneous passage is the preferred first line option for ureteral stones in pregnancy. In refractory renal colic, or if febrile UTI develops with stone obstruction, urological intervention (with or without stone treatment) and stent insertion is required.

Keywords: Urolithiasis, pregnancy, diagnostic imaging, treatment.

Received: January 1, 2022; Revised: April 6, 2022; Accepted: April 13, 2022; Prepublished online: April 13, 2022; Published: June 29, 2022