Ureteroscopy and Laser Lithotripsy for Treatment of Ureteral Stones in Pregnants: Single Center Experience

Özet

Objective: To report our ureteroscopic laser lithotripsy experiences in the treatment of symptomatic ureter stones in pregnants which do not respond to conservative treatmentMethods: A total of 6 pregnants aged between 22-33 years in second or third trimester were studied. Holmium-YAG laser lithotripsy was performed with 6.5 F semirigid uretroscope.Results: The diagnosis of ureter stone was made with abdominal ultrasonography in 5 patients and with magnetic resonance in one patient. Adequate stone fragmentation was performed in 2 mid-ureter and 4 distal-ureter stones. J stent was applied in one patient after the fragmentation process. The mean operation time was 24.8 ± 10.0 minutes after the entry of bladder with ureteroscope under spinal anesthesia. No urologic, anesthetic or obstetric complication was seen and all patients gave healthy birth at term.Conclusion: Fine calibrated ureteroscopes for the treatment of ureter stones in pregnants are fast and effective treatment modalities which decrease the operation time and remove difficulties in entering the ureter.Key words: Pregnancy, urolithiasis, ureteroscopy, lithotripsy, Holmium-YAG laser

Abstract

Objective: While there are suggestions for oral hydration times after general anesthesia, there is no published study with regard to sedation. The aim of this prospective study was to determine a safe time for oral intake after pediatric sedation and its association with nausea and vomiting after discharge.Methods: A total of 180 children (aged 1 month to 13 years) sedated for magnetic resonance imaging were randomly assigned into three groups. All patients fasted for 6 hours and were allowed to take clear fluids until 2 hours before sedation with thiopental (3 mg/kg). After the patients were transported to the recovery room, we allowed the patients to drink as much clear fluids as they wanted prior to discharge in group I, 1 hour after the patients met the discharge criteria for group II, and 2 hours after the patients met the discharge criteria for group III. All patients were assessed for vomiting in the recovery room until 1 hour after their first oral hydration. The parents were then telephoned the next day and questioned regarding nausea/vomiting and any unanticipated hospital admission.Results: There were no statistically significant intergroup differences with respect to age, sex, weight, or the ASA status. There was no nausea and vomiting in either the recovery or post discharge period in any group. In the telephone questionnaire, no hospital admissions were reported.Conclusion: Oral hydration just before discharge is safe, and fasting children after discharge for a period of time is unnecessary for patients sedated with thiopental.Key words: Sedation, oral intake, postoperative nausea and vomiting

Anahtar kelimeler: Gebelik, ürolitiyazis, üretereskopi, litotripsi, Holmium-YAG lazer