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Nefrolitotomía percutánea en el embarazo: una revisión integral y perspectivas técnicas

Daniel Pérez-Fentes¹, Esteban Emiliani², Ernesto Donoso¹

¹Endourology Unit, Urology Department, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.

Asian journal of urology

|December 30, 2025

Resumen

La nefrolitotomía percutánea (NLPC) es una opción segura y viable para mujeres embarazadas con cálculos urinarios cuando el tratamiento conservador falla. Este procedimiento mínimamente invasivo, cuando lo realizan equipos experimentados, no presenta complicaciones maternas ni fetales reportadas.

Área de la Ciencia:

Urología
Obstetricia
Nefrología

Sus antecedentes:

Los cálculos urinarios durante el embarazo a menudo requieren manejo conservador o drenaje temporal.
La nefrolitotomía percutánea (NLPC) generalmente se evita debido a su invasividad y uso de fluoroscopia.
La intervención puede ser necesaria en casos seleccionados de cálculos urinarios relacionados con el embarazo.

Objetivo del estudio:

Revisar la literatura sobre el uso de la nefrolitotomía percutánea (NLPC) en el embarazo.
Evaluar la seguridad, eficacia y viabilidad de la NLPC en pacientes embarazadas.
Explorar los aspectos técnicos de la realización de la NLPC durante la gestación.

Principales métodos:

Se realizó una revisión narrativa de la literatura de enero de 2000 a marzo de 2024.
Las bases de datos consultadas incluyeron PubMed, Embase y Scopus.
Seis estudios que involucraron a 14 pacientes embarazadas cumplieron los criterios de inclusión.

Principales resultados:

Los estudios incluyeron pacientes de 23 a 34 años, entre las semanas 8 y 28 de gestación.
Las imágenes preoperatorias se basaron únicamente en ecografía.
El tamaño de los cálculos varió de 8 a 48 mm.
La NLPC se indicó para dolor persistente o reticencia al reemplazo del stent.
Se evitó la fluoroscopia en 13 pacientes, sin complicaciones maternas ni fetales.

Conclusiones:

La nefrolitotomía percutánea (NLPC) es un tratamiento viable para casos específicos de cálculos urinarios en el embarazo.
La realización de NLPC requiere centros experimentados, asesoramiento al paciente y un enfoque multidisciplinario.
El procedimiento demostró seguridad y viabilidad en la literatura revisada.

Palabras clave:

Cálculo renal Resultado Nefrolitotomía percutánea Embarazo Urolitiasis

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