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Title |
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Radiation-Free Double-Pigtail Stent Insertion Under Local Anaesthesia For Managing Acute Calcular Ureteral Obstruction During The Last Trimester Of Pregnancy. |
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BY |
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*M. H. El-Shazly, and **Nagwa A. Ghaffar.
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*Urology Department; El-Sahel Teaching Hospital; **Ob/Gyn Department, Al Azhar University (Girls), Cairo, Egypt. |
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ABSTRACT |
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Objective: To evaluate the feasibility, efficacy, and clinical outcome of the radiation-free endo-insertion of double-pigtail ureteral stents under local anaesthesia for managing acute calcular ureteral obstruction during the last trimester of pregnancy. Patients and methods: Radiation-free endo-insertion of double-pigtail ureteral stent under local anaesthesia was used as an emergency management for managing acute ureteral obstruction, not responding to conservative measures, in twenty nine pregnant women during the last trimester. The nature of ureteral obstruction was lower ureteral stone in 19/29 (65.5%) patients, mid ureteral stone in 1/29 (3.4%) patients, and upper ureteral stone in 9/29 (31.0%) patients. Results: The procedure was feasible in 26/29 (89.7%) patients and failed in 3/29 (10.3%) patients due to stone impaction. Clinical improvement occurred in all successful cases. However, the stent had to be removed due to persistent marked irritative dysuria in 2/26 (7.7%) cases within ten days of its insertion. Details of the clinical outcome and adverse effects will be presented. No major complications were recorded. Conclusion: Radiation-free endo-insertion of double-pigtail ureteral stent under local anaesthesia is a feasible, safe, minimally invasive, and effective procedure for managing acute calcular ureteral obstruction, not responding to conservative measures, during the last trimester of pregnancy.
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