Ureteroscopy during pregnancy

Urolithiasis during pregnancy is an uncommon, but a serious medical problem. Options for the treatment of pregnant women with obstructing stones include ureteral stent placement, percutaneous nephrostomy tube placement, and ureteroscopic stone removal (URS). Although ureteral stent and nephrostomy tube placement have been the historically standard treatment option for pregnant women with obstructing stones, there is an emerging collection of literature that reviews the safety of URS for pregnant women. We performed a systematic review of MEDLINE and EMBASE from January 1966 through April 2009 to identify all literature on URS in pregnant women. Herein, we review the literature on URS during pregnancy, with a focus on the safety of this approach. We conclude that URS is an appropriate intervention in the pregnant population with urolithiasis; in all cases the procedure should be performed on a properly selected patient by a surgeon with appropriate experience and equipment. With such an approach, complication rates are low and success rates are high. A multidisciplinary approach should be emphasized as a key to a successful outcome.