Mustafa Okan İSTANBULLUOĞLU, Hüsnü ALPTEKİN, Hatice IŞIK, İbrahim BULDU

Gebelerde Üreter Taşı Tedavisinde Üreteroskopi ve Lazer Litotripsi: Tek Merkez Deneyimi

Amaç: Gebelerde konservatif tedavi ile sonuç alınama- yan semptomatik üreter taşlarının tedavisinde üreteros- kopik lazer litotripsi deneyimlerimizi sunmak. Yöntemler: Yaşları 22 ile 33 arasında değişen tümü 2. veya 3. trimesterde toplam 6 gebe hasta çalışmaya alın- dı. Hastalara 6,5 F semiri jit üreteroskop ile Holmium-YAG lazer litotripsi uygulandı. Bulgular: Üreter taşı tanısı 5 hastada abdominal ultra- sonografi ile, 1 hastada manyetik rezonans görüntüleme ile konuldu. 2 orta, 4 alt üreter taşının tümünde yeterli taş fragmantasyonu sağlandı. 1 hastada işlem sonrası J stent uygulandı. Spinal anestezi altında, üreteroskop ile mesa- neye girildikten sonra, ortalama operasyon süresi 24,8 ± 10,0 dk idi. Ürolojik, anestezik veya obstetrik komplikas- yon gözlenmedi ve tüm hastalar miadında sağlıklı doğum- larını gerçekleştirdi. Sonuç: Gebelerde üreter taşlarının üreteroskopi ile teda- visinde ince kalibrasyon üreteroskoplar ameliyat süresini kısaltacak üretere girişte zorluk çıkartmayacak hızlı ve etkin tedavi araçlarıdır.

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

Objective: To report our ureteroscopic laser lithotrip- sy experiences in the treatment of symptomatic ureter stones in pregnants which do not respond to conservative treatment Methods: 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 ab- dominal 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 fragmenta- tion process. The mean operation time was 24.8 ± 10.0 minutes after the entry of bladder with ureteroscope un- der spinal anesthesia. No urologic, anesthetic or obstetric complication was seen and all patients gave healthy birth at term. Conclusion: Fine calibrated ureteroscopes for the treat- ment of ureter stones in pregnants are fast and effective treatment modalities which decrease the operation time and remove difficulties in entering the ureter.

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