Management of Urolithiasis during Pregnancy

Urinary stone disease in pregnancy is an important clinical scenario which presents unique challenges to the urologist. In order to ensure safe and comprehensive care of both the mother and the fetus, a multidisciplinary approach is highly recommended. A high degree of suspicion is required for the prompt and accurate diagnosis of renal colic during pregnancy. Given the potential serious risks of radiation exposure during pregnancy, careful consideration must be given to the use of diagnostic imaging in this context. Management must be individualized to the patient and clinical situation but generally proceeds from conservative to more invasive approaches. Expectant management is recommended as first-line treatment when there are no contraindications. However, recent advances in endourological equipment and techniques and obstetrical care have allowed for an increased role of primary surgical management with ureteroscopy. It is essential for the practicing urologist to understand the intricacies of diagnosing and managing stone disease in pregnancy in order to reduce the potential for patient morbidity and complications.