Outcomes of ureteroscopy and internal ureteral stent for pregnancy with
urolithiasis: a systematic review and meta-analysis
Abstract
Objectives To investigate the outcomes of internal ureteral stent versus
ureteroscopy for pregnant women with urolithiasis. Data Sources Relevant
studies published from January 1980 to April 2020 were identified
through a systematic literature search in MEDLINE, EMBASE, Web of
Science and Cochrane Library. Study Eligibility Criteria Total of 453
studies were initially identified. Pregnant women in any pregnancy
stages who underwent D-J stent insertion only or ureteroscopy operation
were included. The number of related participants in each group of study
should be more than 10. This systematic review has been registered on
PROSPERO (CRD42020195607). Results A total of 25 studies were identified
with 131 cases serial stenting and 789 cases URS. The pooled operation
success rate was 97% for D-J stent insertion, and 99% for URS. For
internal ureteral stent therapy, normal fertility outcome rate was 99%,
but the pooled incidence of complications was about 45%. For the URS
group, normal fertility outcome rate was 99%, and the pooled incidence
of complications was about 1%. However, the pooled premature and
abortion incidence rate of two groups were the same as less than 1%,
and same in serious complication incidence rate. Conclusions Although
internal ureteral stent may cause more slight complications,
ureteroscopy operation and internal ureteral stent showed less side
effective on fertility results. Evidence suggests that URS therapy have
greater advantage for pregnancy with urinary stones when the condition
permits. As it is proved safe and effective, internal ureteral stent
could be considered at emergency or other special situations.