Table 3 Summary of details for URS group
First author | Year | Anesthetic method | No. of operations (success rate) | Tool | SFR, % | Fertility outcome | Complications | Complications (classified) | Follow-up pattern |
|---|---|---|---|---|---|---|---|---|---|
Ulvik[8] | 1995 | Epidural anesthesia in 23; spinal anesthesia in 1; pethidine intravenously in 1 | 25 (100%) | 11.5F rigid URS in 23 and 9.5F rigid URS in 2 | Not mentioned | Deliveries normal in 19; cesarean section in 2; seven weeks premature in 1; elective termination unrelated to ureteroscopy in 1; 1 unknown | Fever in 3 (treated with antibiotics); irritative bladder symptom in 1 | Clavien-Dindo I in 1; Clavien-Dindo II in 3 | IVP or ultrasound 3Â months after delivery |
Scarpa[9] | 1996 | Without anesthetic in 5; neuroleptic analgesia in 10 | 15 (100%) | 7F rigid URS in 14 and 9.5F rigid URS in 1 (pulsed dye laser in 3, YAG laser in 3, ballistic lithotriptor in 2) | Not mentioned | All 15 delivered at term | 0 | 0 | Not mentioned |
Lemos[11] | 2002 | Epidural anesthesia | 14 (100%) | 7F or 10F URS in 14 (11 removed stone with basket; 2 underwent ultrasonic lithotriptor) | 100 | All 14 delivered at term | 0 | 0 | Not mentioned |
Rana[12] | 2009 | General anesthesia | 19 (100%) | 6.9F/8F semi-rigid URS with pneumatic lithoclast (5 need ureteral balloon dilator) | 79 | Not mentioned | 0 | 0 | Clinical assessment, ultrasound examination, and urine samples for culture and sensitivity |
Elgamasy[13] | 2010 | General anaesthesia in 10; spinal anaesthesia in 5 | 15 (100%) | 9.5F URS (5 need balloon dilation; 12 Dormia basket or pneumatic lithotripter; 2 forceps; 1 no stone) | Not mentioned | 14 delivered at term; 1 premature labour (36Â week) | D-J stent migration in 1 | Clavien-Dindo III in 1 | Patients were followed closely until delivery |
Liu[14] | 2011 | Not mentioned | 24 (100%) | Not mentioned | Not mentioned | 21 natural delivery; 1 abortion; 1 cesarean | Not mentioned | Not mentioned | Not mentioned |
Polat[15] | 2011 | General anesthesia | 16 (100%), 11 with complete fragmentation of the calculi; 5 with stone push-back | 9.5F semi-rigid URS with lithoclast | 72.73 | All 16 delivered at term | 0 | 0 | Obstetric care; clinical assessment, ultrasound examination, and urine culture |
Atar[16] | 2012 | Spinal anesthesia in 18; general anesthesia in 1 | 19 (100%) | 9.5F semi-rigid URS in 19 (holmium laser lithotripsy in 15 and stone forceps in 2) | Not mentioned | All 19 delivered at term | Dysuria-pain in 4; urinary infection in 1 | Clavien-Dindo I in 4; Clavien-Dindo II in 1 | Clinical assessment, US examination, and urine sample collection for culture and antibiogram |
Bozkurt[17] | 2012 | Spinal anaesthesia in 22; general anaesthesia in 7; local anaesthesia in3 | 32 (100%) | 9.5F semi-rigid URS (balloon dilator with pneumatic lithotripsy in 8, holmium laser in 17, then extracted with forceps; 2 extracted with forceps only) | 100 | All 32 delivered at term | Urinary infection in 4; dysuria-pain in 2; sepsis in 1; ureteral laceration in 2 | Clavien-Dindo I in 4; Clavien-Dindo II in 4; Clavien-Dindo IV in 1 | Obstetric care; clinical assessment, US examination, and urine samples for culture and antibiogram |
Hoscan[18] | 2012 | Genaral anesthesia | 57 (100%) | 9.5F semi-rigid URS | 85.3 | Not mentioned | Urinary tract infection in 3; bladder irritation in 3; uterine contraction in 1 | Clavien-Dindo I in 3; Clavien-Dindo II in 4 | Obstetric care; clinical assessment, ultrasound examination, and urine culture |
Johnson[19] | 2012 | General anesthesia in 32; local anesthesia in 5; epidural or spinal anesthesia in 9 | 46 (100%), 39 with stone | Flexible scope in 8, rigid scope in 21, Both scope in 17; Lithotripsy in 24, basket extraction in 37 | 86 | 44 delivered at term; preterm labor in 2 | Not mentioned | Not mentioned | Not mentioned |
Abdel[20] | 2013 | Spinal anesthesia | 17 (100%), 13 with pneumatic lithoclast,4 with dormia extraction | 7.3/8 F semi-rigid URS (Storz) and 6/7.5 F semi-rigid ureteroscope (Wolf) | 100 | All 17 delivered at term | 0 | 0 | Clinical assessment, abdominal ultrasonography, and urine culture and sensitivity. Radiographic imaging with KUB was done in the postpartum period |
Bozkurt[21] | 2013 | Spinal anesthesia in 34; general anesthesia in 3; other in 4 | 41, 37 success (90.2%) | 9.5F semi-rigid URS (laser lithotripsy in 27, pneumatic lithotripsy in 6 and stone extraction in 4) | 85.5 | All 41 delivered at term | Laceration in 3; perforation in 1; urinary infection in 4; dysuria-pain in 6; sepsis in 1 | Clavien-Dindo I in 9; Clavien-Dindo II in 4; Clavien-Dindo III in 1; Clavien-Dindo IV in 1 | Clinical assessment, US and urine samples for culture and antibiogram |
Song[22] | 2013 | Epidural anesthesia in 21 | 21, 18 success (85.7%) | Wolf URS and LithoClastMaster | 85.7 | All 21 delivered at term | Hematuria in 2; stent-induced bladder irritation in 1 | Clavien-Dindo I in 3; | Not mentioned |
Keshvari[23] | 2013 | General anesthesia | 44 (100%) | 8F semi-rigid URS (pneumatic lithotripsy in 34, stone extraction with grasper in 16) | 100 | All 44 delivered at term | 0 | 0 | Obstetric care; clinical assessment, ultrasound examination, urinalysis and urine culture |
Adanur[25] | 2014 | General anaesthesia without using halothane and nitric oxide | 19 (100%) | 7.5 F or 9.5 F semi-rigid URS (holmium-YAG laser in 19, a forcep for extraction of stone fragment in 9) | Not mentioned | All 19 delivered at term | Preterm urterin conrtaction in 1 and treated with tocolysi; urinary tract ingection in 1 and treated with appropriate antibiotics | Clavien-Dindo II in 2 | Not mentioned |
Georgescu[26] | 2014 | Spinal anesthesiain 42; general anesthesia 12 | 54, 44 success (81.5%) | Semi-rigid URS used during first 2 trimesters (32 success from 38 patients); flexible URS (12 from 16 cases) in the last trimester | Not mentioned | All 54 delivered at term; uterine contraction in 1 | Urinary tract infection developed in 4 patients; renal colic in 2; prolonged hematuria in 1; stent-induced bladder irritation in 4 | Clavien-Dindo I in 6; Clavien-Dindo II in 6 | Obstetric care, clinical assessment, ultrasound examination, urinalysis and urine culture |
Teleb[27] | 2014 | Spinal anaesthesia in 19; topical lidocaine anaesthesia with sedo-analgesia in 2 | 21 (100%) | 9.5F semi-rigid URS (dilatation of ureteric orifice in 4, pneumatic lithoclast in 14, directly extracted stone in 7) | 100 | All 21 delivered at term | Urinary tract infection in 2; irritative bladder symptom in 4 | Clavien-Dindo I in 4; Clavien-Dindo II in 2 | US and urinalysis every 4 wks |
Wang[28] | 2014 | Local anesthesia | 64 (100%) | 8/ 9.8F rigid URS (lithotripsy with Holmium:YAG laser) | 81.3 | All 64 delivered at term | Threatened abortion in 1; mild ureteric laceration in 1; mild bleeding in 5 | Clavien-Dindo I in 6; Clavien-Dindo II in 1 | Obstetric care; clinical assessment, ultrasound examination and urine culture |
Fathelbab[29] | 2016 | Epidural anesthesia | 41 (100%) | Semi-rigid URS ( pneumatic lithoclast in 22, directly extracted stone in 4) | 89.7 | All 41 delivered at term | Stent-related mild dysuria in 12; hematuria in 5, | Clavien-Dindo I in 17 | Not mentioned |
Zhang[30] | 2016 | General anesthesia in 72; spinal anesthesia in 45 | 117 (100%) | 9.5F semi-rigid URS or flexible URS (pneumatic ballistic lithotripsy or Holmium:YAG laser) | 84.6 | All 117 delivered at term | Urosepsis in 1; threatened abortion in 12 | Clavien-Dindo II in 12; Clavien-Dindo IV in 1 | Obstetric care; clinical assessment, ultrasound examination, urinalysis and urine culture |
Abedi[31] | 2017 | Not mentioned | 45 (100%) | 9.5F semi-rigid URS (holmium-YAG laser) | 93.3 | All 45 delivered at term | Preterm urterin conrtaction in 2 and treated with tocolysi; urinary tract ingection in 2 and treated with appropriate antibiotics | Clavien-Dindo II in 4 | Not mentioned |
Tan[32] | 2018 | General anesthesia or epidual anesthesia | 23, 20 success (87%) | URS lithotripsy with pneumatic lithotripsy | Not mentioned | Not mentioned | Bladder irritation in 1; sliht hematuria in 1 | Clavien-Dindo I in 2 | Not mentioned |