Surgical management of symptomatic right ureteric calculus in a pregnant woman with moderate hydroureteronephrosis
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20261306Keywords:
Ureteric calculus, Hydroureteronephrosis, Pregnancy, DJ stenting, G4P2L2MTP1Abstract
Renal and ureteric calculi are relatively uncommon during pregnancy, often posing significant diagnostic and management challenges. This due to the physiological changes of pregnancy and need for fetal safety. We present a case involving a 30-year-old woman G4P2L2MTP1 at 21+5 weeks gestation presenting with a symptomatic right proximal ureteric calculus and right moderate hydroureteronephrosis. We opted for surgical intervention via ureteroscopy and Double-J (DJ) stenting as conservative efforts failed to prevent the risk of urosepsis. Post procedure antenatal care was uneventful, a healthy infant was delivered via emergency caesarean section at 36+1 weeks with the stent in situ, followed by successful removal of DJ stent 6 weeks postpartum. This case highlights the necessity of timely intervention and successful collaborative efforts of obstetric and urological teams.
References
Butler EL, Cox SM, Eberts EG, Cunningham FG. Symptomatic nephrolithiasis complicating pregnancy. Obstet Gynecol. 2000;96(5):753-6.
Maikranz P, Coe FL, Parks JH. Nephrolithiasis and gestation. Bailliere's Clin Obstet Gynaecol. 1987;1(4):909-19.
Masselli G, Derme M, Bernieri MG, Polettini E, Casciani E, Bertini L, et al. Stone disease in pregnancy: Image-guided diagnosis and therapy. Insights Imaging. 2014;5(6):697-706.
American College of Obstetricians and Gynecologists (ACOG). Guidelines for Diagnostic Imaging During Pregnancy and Lactation. Obstet Gynecol. 2017;130(4):e210-6.
Tangren JS, Powe CE, Ecker J, Bramham K, Ananth CV, Karumanchi SA, et al. Clinical Outcomes and Management of Urolithiasis in Pregnancy. Front Med. 2018;5:242.
Türk C, Skolarikos A, Neisius A, Petrik A, Seitz C, Thomas K, et al. EAU Guidelines on Urolithiasis. European Association of Urology Guidelines Office. 2023. Available at: https://uroweb.org/guidelines/urolithiasis. Accessed on 15 February 2026.
Pearle MS, Goldfarb DS, Assimos DG, Curhan G, Denu-Ciocca CJ, Matlaga BR, et al. Medical management of kidney stones: AUA guideline. J Urol. 2014;192(2):316-24.
Semins MJ, Matlaga BR. Management of urolithiasis in pregnancy. Int J Women's Health. 2014;6:517-21.
Johnson EB, Kneissel JP, Kukulka NA, Grubb RL. Ureteroscopy during pregnancy: Is it safe?. J Endourol. 2007;21(11):1311-4.