Minimally-invasive stone removal in urinary calculi patients during pregnancy: clinical therapeutic effects and low complications

Am J Transl Res. 2021 Aug 15;13(8):9614-9620. eCollection 2021.

Abstract

Purpose: To study the clinical effect of minimally-invasive surgery to treat urinary calculi and the prevention of surgery-associated complications during pregnancy.

Methods: A retrospective analysis of the clinical data of 96 pregnant urinary calculi patients admitted to our hospital from April 2017 to April 2018 was conducted. The patients were randomly divided into a study group and a control group, with 48 patients in each group. The control group was given extracorporeal shock wave lithotripsy (ESEL), and the study group underwent minimally-invasive percutaneous nephrolithotomies (MPCNL). The clinical efficacy and the complications associated with the two treatments were compared.

Results: The two groups' BUN and SCr levels were significantly decreased after the treatment (P < 0.05), with more significant reductions in the study group than in the control group (P < 0.001). There were marked reductions in the IL-6 and ET-1 levels in the two groups of patients post-treatment (P < 0.001), with greater decreases in the study group than in the control group (P < 0.001). The post-treatment CA and GLU levels were significantly lower than their pre-treatment values (P < 0.001), with greater decreases in the study group than in the control group (P < 0.001). Moreover, the patients' pain scores in the study group at post-surgery days 1, 3, and 5 were significantly lower than the post-surgery pain scores in the control group (P < 0.001). There were no significant differences in the stone removal rates between the two groups (P > 0.05). The Incidence of postoperative complications in the study group was significantly lower than the incidence in the control group (P < 0.05).

Conclusion: The use of MPCNL for patients with urinary calculi during pregnancy effectively improves renal function, decreases the inflammatory and stress responses, and lowers the postoperative pain. Therefore, this treatment merits clinical application.

Keywords: Urinary calculi; minimally-invasive stone removal; pregnancy; reduced complications; treatment outcomes.