Pyrah Department of Urology, St James's University Hospital, Leeds UK. Introduction. 'For the sake ..... 29 Swanson SK, Heilman RL, Eversman WG. Urinary tract.
BJU International (2002), 89, 811–818
Urolithiasis in pregnancy. I: pathophysiology, fetal considerations and diagnosis C . S . B I YA N I and A . D . J O Y C E Pyrah Department of Urology, St James’s University Hospital, Leeds UK
Introduction ‘For the sake of diagnostic precision we should distinguish between the sickness of pregnancy and sickness in pregnancy.’ William Smellie, 1752 [1].
Urolithiasis in pregnancy represents a major diagnostic and therapeutic challenge to the GP, obstetrician, urologist, radiologist and anaesthetist. Urolithiasis presenting during pregnancy is a cause of major concern, considering the potential adverse effects of radiation exposure, any invasive surgical procedures and anaesthesia on the mother and fetus. The incidence of urolithiasis during pregnancy is 0.026–0.531% [2,3], complicates 1 : 200 to 1 : 2000 pregnancies [4] and may be a contributing factor in up to 40% of premature births [3]. The incidence of symptomatic stones has been calculated to be the same during pregnancy as in nonpregnant women of childbearing age [5]. Multiparous women seem to be affected more often than primiparae by a ratio of