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Original ArticleOpen Access
Ureteral Calculi During Pregnancy : Review of the Management at Ramathibodi Hospital
Kochakam W 
,
Viseshsindh V ,
Muangman V
,
Viseshsindh V ,
Muangman V KRISADA RATANA-OLARN, M.D.*,
VERASING MUANGMAN, M.D.*
Objective
: To review our experiences with diagnosis and management of symptomatic
ureteral calculi complicating pregnancy.
Material and Method
: Medical records of all pregnant patients documented with sym-
ptomatic ureteral calculi treated at the Division of Urology, Department of Surgery, Faculty of
Medicine, Ramathibodi Hospital from 1990 to 2000 were reviewed. Presenting symptoms, diagnostic
studies and management of ureteral stone were evaluated.
Results
: Twenty patients were found in this study with the mean age of 27.5 years (18-
36). The mean gestational age at presentation was 18.5 weeks (12-33). Severe flank pain was the
common presenting symptom (100%), 60 per cent were on the right side and 40 per cent were on
the left side, 20 per cent had associated fever and 20 per cent had irritative voiding symptoms. All
of the cases had micro or macroscopic hematuria. Ultrasonography was the initial test confirming
the diagnosis and visualized stones were obtained in 60 per cent of the cases. Plain KUB film was
done in 6 cases and stones could be seen in 5 cases (83% ). Limited IVP was done in 3 cases
and the diagnosis could be done in all of them ( 100% ). Spontaneous passing of stones was noted
in 14 cases (70%) and double J stents were placed in 6 cases. Ureterolithotomy was done in 2
cases and percutaneous nephrostomy with subsequent definite stone treatment in the post partum
period was done in 2 cases. No abortion and no congenital anomalies of the infant were noted.
Four cases had premature labor but there was no correlation with the procedures performed for
treating the ureteral stone.
434
W.
KOCHAKARN
VERASING MUANGMAN, M.D.*
Objective
: To review our experiences with diagnosis and management of symptomatic
ureteral calculi complicating pregnancy.
Material and Method
: Medical records of all pregnant patients documented with sym-
ptomatic ureteral calculi treated at the Division of Urology, Department of Surgery, Faculty of
Medicine, Ramathibodi Hospital from 1990 to 2000 were reviewed. Presenting symptoms, diagnostic
studies and management of ureteral stone were evaluated.
Results
: Twenty patients were found in this study with the mean age of 27.5 years (18-
36). The mean gestational age at presentation was 18.5 weeks (12-33). Severe flank pain was the
common presenting symptom (100%), 60 per cent were on the right side and 40 per cent were on
the left side, 20 per cent had associated fever and 20 per cent had irritative voiding symptoms. All
of the cases had micro or macroscopic hematuria. Ultrasonography was the initial test confirming
the diagnosis and visualized stones were obtained in 60 per cent of the cases. Plain KUB film was
done in 6 cases and stones could be seen in 5 cases (83% ). Limited IVP was done in 3 cases
and the diagnosis could be done in all of them ( 100% ). Spontaneous passing of stones was noted
in 14 cases (70%) and double J stents were placed in 6 cases. Ureterolithotomy was done in 2
cases and percutaneous nephrostomy with subsequent definite stone treatment in the post partum
period was done in 2 cases. No abortion and no congenital anomalies of the infant were noted.
Four cases had premature labor but there was no correlation with the procedures performed for
treating the ureteral stone.
434
W.
KOCHAKARN
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