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Can Urol Assoc J 2020 May 12. Epub 2020 May 12.

Department of Urology, Dalhousie University, Halifax, NS, Canada.

Urological issues in the pregnant patient present a unique clinical dilemma. These patients may be challenging to treat due to risks associated with medications and surgical procedures. This review aims to provide an update on the physiological changes and surgical risks in pregnancy. Read More

J Invest Surg 2020 Mar 31:1-4. Epub 2020 Mar 31.

Division of Perinatology, Hacettepe University, Ankara, Turkey.

To investigate the relationship of cholelithiasis and urolithiasis with (MTHFR) polymorphism(s) in patients with poor obstetric history to search whether they are risk factors for adverse pregnancy outcome. This study is consisted of 94 patients with poor obstetric history. Patients were evaluated in terms of the presence of cholelithiasis and urolithiasis in association with MTHFR polymorphism(s). Read More

Turk J Urol 2020 03 1;46(2):89-94. Epub 2020 Mar 1.

Urological Surgery Department, University Hospital Southampton NHS Trust, Southampton, UK.

Objective: Management of nephrolithiasis during pregnancy can be challenging because of the potential risks to the mother and fetus. Diagnosis and treatment can be a dilemma owing to the anatomical and physiological changes, besides the limitation in the use of X-rays. The aim of this article was to identify any case series or case reports where percutaneous nephrolithotomy (PCNL) was used as a treatment modality for nephrolithiasis in pregnancy. Read More

Am Fam Physician 2020 03;101(5):275-285

Naval Hospital Jacksonville, Jacksonville, FL, USA.

Point-of-care ultrasonography (POCUS) is performed by a physician at the bedside and is standard practice in obstetric, emergency, and musculoskeletal medicine. When compared with formal sonography, POCUS is equivalent in screening for abdominal aortic aneurysm and as accurate in diagnosing deep venous thrombosis. POCUS has high accuracy for diagnosing pneumonia and detecting acute decompensated heart failure but is less accurate than computed tomography for identifying pulmonary embolism. Read More

World J Urol 2019 Nov 25. Epub 2019 Nov 25.

Division of Urology, Department of Surgery, CHU de Québec-Université Laval, Hôpital Saint-François D'Assise, 10 rue de l'Espinay, Ville de Québec, QC, G1L 3K5, Canada.

Purpose: Use of medical expulsive therapy (MET) is common practice in urology for the treatment of symptomatic urolithiasis, despite this its efficacy is debated. Its use in pregnancy is controversial. Our objective was to evaluate the safety and efficacy of Tamsulosin as a MET in pregnant women. Read More

J Urol 2020 05 18;203(5):957-961. Epub 2019 Nov 18.

Department of Urology, Stanford University School of Medicine, Stanford, California.

Purpose: Urinary stone disease during pregnancy is poorly understood but is thought to be associated with increased maternal and fetal morbidity. We determined the prevalence of urinary stone disease in pregnancy and whether it is associated with adverse pregnancy outcomes.

Materials And Methods: We identified all pregnant women from 2003 through 2017 in the Optum® national insurance claims database. Read More

Cir Cir 2019 ;87(S1):62-67

Departamento de Cirugía General, Hospital General de México "Dr. Eduardo Liceaga", Ciudad de México, México.

Background: Primary hyperparathyroidism (PHPT) is characterized by an increase in parathyroid hormone (PTH) and hypercalcemia, which, when present during pregnancy, increases both maternal and fetal morbidity and mortality.

Objective: Emphasize the importance of surgical intervention in primary hyperparathyroidism during pregnancy.

Clinical Case: A 27-year-old female with a pregnancy of 27. Read More

Med Glas (Zenica) 2019 Aug 1;16(2). Epub 2019 Aug 1.

Clinic of Anaesthesiology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina.

Aim To identify short-term effects of extracorporeal shock wave lithotripsy (ESWL) on renal function in children and adolescents with single kidney stones. Methods In a 4-year period 30 children (15 boys and 15 girls) from 10 to 18 years of age were treated for unilateral renal stones with ESWL. Inclusion criteria were: up to 18 years of age, kidney stone (from 4 to 20 mm in diameter) visible on X-ray, first ESWL treatment, unilateral lithotripsy treatment without previous kidney surgery, patients without infravesical obstruction, patients without proven urinary infection, repeated use of one (the same) analgesic, patients without anticoagulant and antihypertensive therapy, patients without use of nephrotoxic drugs prior to and during the treatment, normal blood pressure, non-pregnancy patients with normal renal function. Read More

Prim Care 2019 Jun;46(2):203-212

Department of Family and Community Medicine, University of Kansas School of Medicine - Wichita, Hillside Medical Office 855 N. Hillside Wichita, KS 67214, USA. Electronic address:

Incidence of nephrolithiasis has increased dramatically over the past 30 years, likely due to environmental changes such as dietary habits. Nephrolithiasis presents as acute flank or abdominal pain with nausea and vomiting. Hematuria is present in 90% of cases, but its absence does not rule out nephrolithiasis. Read More

Eur J Pediatr 2019 Jun 19;178(6):823-828. Epub 2019 Mar 19.

Pediatric Urology, Konya Training and Research Hospital, Hacı Şaban Mah., Yeni Meram Cad. No: 97, 42090, Konya, Turkey.

Data regarding spontaneous resolution of mild hydronephrosis consist of different etiologies, and hence, it is heterogeneous. The aim of this study is to evaluate spontaneous resolution rates and the time to complete resolution of antenatally detected isolated hydronephrosis in patients with renal pelvis antero-posterior diameter (RPAPD) ≤ 20 mm. Retrospective chart review of patients who were admitted to our pediatric nephrology clinic for the evaluation of antenatal hydronephrosis between 2011 and 2017 was conducted. Read More

J Endocr Soc 2019 Feb 17;3(2):387-396. Epub 2018 Dec 17.

Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.

Gene variants of , which encodes the enzyme 24-hydroxylase, are a most unusual cause of maternal hypercalcemia. Loss-of-function mutations in result in impaired dehydroxylation of active vitamin D (calcitriol). Secondary to this hypercalcemia, hypercalciuria and suppressed parathyroid hormone (P-PTH) can develop. Read More

Am J Case Rep 2018 Dec 30;19:1546-1549. Epub 2018 Dec 30.

Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Division, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

BACKGROUND Bladder stones are rare in pregnancy, and can be associated with adverse outcomes such as recurrent urinary tract infection and obstruction of labor. Management of bladder stones discovered in pregnancy has traditionally been done via open techniques such as cystolithotomy or with percutaneous removal. Our objective was to present a case of bladder stone in pregnancy and review prior reports on bladder stones and management in pregnancy. Read More

Mayo Clin Proc 2019 02 4;94(2):202-210. Epub 2018 Dec 4.

Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN; Division of Epidemiology, Mayo Clinic, Rochester, MN. Electronic address:

Objective: To predict symptomatic recurrence among community stone formers with one or more previous stone episodes.

Patients And Methods: A random sample of incident symptomatic kidney stone formers in Olmsted County, Minnesota, was followed for all symptomatic stone episodes resulting in clinical care from January 1, 1984, through January 31, 2017. Clinical and radiographic characteristics at each stone episode predictive of subsequent episodes were identified. Read More

Urolithiasis 2019 Oct 27;47(5):441-448. Epub 2018 Oct 27.

Department of Urology, Loyola University Medical Center, Maywood, IL, 60153, USA.

Antepartum nephrolithiasis presents a complex clinical scenario which often requires an intervention such as ureteral stent or percutaneous nephrostomy tube (PCNT) placement, especially in the setting of urinary tract infection (UTI). We assess the risk of UTI and preterm labor in the setting of antepartum nephrolithiasis. A retrospective review of an administrative dataset for California and Florida was performed, which included pregnant women admitted for a delivery between 2008 and 2011. Read More

Asian J Urol 2018 Oct 5;5(4):223-234. Epub 2018 Jun 5.

Division of Urology, Department of Surgery, Western University, London, Canada.

Urinary stone disease is a highly prevalent condition affecting approximately 10% of the population, and has increased in incidence significantly over the past 20 years. Along with this, the rate of stone disease among women and children is also on the rise. The management of stone disease in specific populations, such as in children and during pregnancy can present unique challenges to the urologist. Read More

Ital J Pediatr 2018 Sep 24;44(1):111. Epub 2018 Sep 24.

Division of Perinatal Medicine, Policlinico Abano Terme, Piazza Colombo 1, 35031, Abano Terme, Italy.

Background: Fetal supraventricular tachycardia (SVT), characterized by fetal heart rate between 220 and 260 bpm, is a rare but most commonly encountered fetal cardiac arrhythmia in pregnancy that may be associated with adverse perinatal outcome.

Case Presentation: We describe a 36/6 week near term fetus who presented morphine-induced SVT after maternal treatment of a renal colic. Following emergency cesarean section, the neonate had resolution of symptoms. Read More

Eur J Obstet Gynecol Reprod Biol 2018 10 14;229:199. Epub 2018 Aug 14.

Department of Urology, Shengjing Hospital of China Medical University, Shenyang 110004, PR China.

Eur J Obstet Gynecol Reprod Biol 2018 10 25;229:198-199. Epub 2018 Jul 25.

Department of Obstetrics and Gynecology, Hadassah University Medical Center, Jerusalem, Israel.

Eur J Obstet Gynecol Reprod Biol 2018 Aug 1;227:32-34. Epub 2018 Jun 1.

Department of Urology, Shengjing Hospital of China Medical University, Shenyang, 110004, PR China.

Objective: To describe the efficacy of double-J stent retention and ureteroscopy lithotripsy, we performed a study to evaluate the management of symptomatic ureteral calculi during pregnancy.

Materials And Methods: From January 2005 and June 2015, 53 pregnant women with symptomatic ureteral calculi were admitted and treated in our hospital. According to the treatment techniques, there were divided into two groups: double-J stent retention group (30 cases) and ureteroscopy lithotripsy group (23 cases). Read More

Ther Adv Urol 2018 Apr 8;10(4):127-138. Epub 2018 Feb 8.

Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, New Hampshire 03756-1000, USA.

Urolithiasis is the most common nonobstetric complication in the gravid patient. The experience can provoke undue stress for the mother, fetus, and management team. The physiologic changes of pregnancy render the physical exam and imaging studies less reliable than in the typical patient. Read More

J Am Coll Radiol 2018 05 5;15(5):e5. Epub 2018 Mar 5.

Arch Ital Urol Androl 2017 Dec 31;89(4):287-292. Epub 2017 Dec 31.

Department of Human Pathology - Section of Urology, University of Messina, Messina.

Objective: Clinical presentation of ureteral stones during pregnancy is generally with renal colic pain. The aim of this study is to present our experience in the management of renal colic during pregnancy in emergency settings.

Materials And Methods: 208 pregnant patients who presented to emergency department with renal colic pain and underwent ureteroscopy (URS) due to failed conservative therapy were enrolled in the study. Read More

Clin J Am Soc Nephrol 2018 04 22;13(4):612-619. Epub 2018 Feb 22.

Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.

Background And Objectives: Kidney stones are associated with future development of hypertension, diabetes, and the metabolic syndrome. Our objective was to assess whether stone formation before pregnancy was associated with metabolic and hypertensive complications in pregnancy. We hypothesized that stone formation is a marker of metabolic disease and would be associated with higher risk for maternal complications in pregnancy. Read More

J Pediatr Surg 2017 Dec 2;52(12):2070-2073. Epub 2017 Sep 2.

Department of General and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.

Background/purpose: We report the current status of patients who underwent augmentation cystoplasty (AC) at least 20years previously.

Methods: Surgical history, incidence of urinary tract infection (UTI) and bladder stones, vesicoureteral reflux (VUR), urine cytology, renal function, a colon cancer tumor marker (carcinoembryonic antigen: CEA), and patient outcomes were assessed.

Results: Forty patients who underwent AC (mean age: 34. Read More

Urol J 2017 Nov 4;14(6):5034-5037. Epub 2017 Nov 4.

Shiraz Nephro Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Purpose: Urolithiasis during pregnancy poses risks for mother and the fetus with specific challenges in diagnosis and management. We report our experience with urgent percutaneous nephrolithotomy (PCNL) in seven pregnant patients with symptomatic renal stone in early pregnancy.

Materials And Methods: Seven pregnant patients with symptomatic renal stones were reviewed. Read More

Semin Ultrasound CT MR 2017 Aug 20;38(4):310-326. Epub 2017 Feb 20.

Department of Radiology, Baystate Medical Center, University of Massachusetts Medical School, Springfield, MA.

Pelvic pain is a common complaint in female patients who present to the emergency department. Although encountered frequently, the path to a definitive diagnosis is not always a straightforward one, and imaging offers a valuable tool to aid in this diagnostic challenge. Radiologists must be familiar with the most common etiologies of female pelvic pain in the emergency setting, their imaging characteristics, and the best way to further evaluate challenging clinical presentations. Read More

Cent European J Urol 2017 Jun 11;70(2):175-178. Epub 2017 Jun 11.

University Hospital Southampton NHS Trust, United Kingdom.

Introduction: The prevalence of urolithiasis is increasing worldwide and is causing significant morbidity and cost to the healthcare systems. While ureteroscopy (URS) has been established as a treatment option, our review highlights the expanding role of URS for the management of more complex stones and patients in the modern era.

Material And Methods: Ureteroscopy has shown to have good outcomes with stone free rates (SFR) comparable to other treatment modalities. Read More

Eur Urol Focus 2017 02 5;3(1):46-55. Epub 2017 May 5.

Department of Urology, AMC University Hospital, University of Amsterdam, Amsterdam, the Netherlands.

Context: Retrograde intrarenal surgery has gained substantial popularity worldwide thanks to continuous improvements in technology and techniques, and is now considered one of the first-line treatment options for active removal of renal stones.

Objective: To provide a comprehensive synthesis of the main evidences in literature on the current management of kidney stones by means of retrograde intrarenal surgery (RIRS).

Evidence Acquisition: A review of literature has been conducted using search string "retrograde intrarenal surgery OR flexible ureteroscop* OR ureterorenoscop*", without any language restriction; PubMed, Embase, and Scopus databases were searched in November 2016. Read More

J Lasers Med Sci 2017 28;8(2):84-87. Epub 2017 Mar 28.

Department of Urology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

The aim of our study was to assess the efficacy and safety of laser lithotripsy in pregnant patients. In this retrospective study, we reviewed the 15 pregnant women who have been treated for ureteral stones with semi-rigid ureteroscope and holmium laser at our center between Januarys 2007and April 2015. The mean age of patients and mean gestational age was 29. Read More

Clin Genet 2017 Dec 4;92(6):632-638. Epub 2017 Oct 4.

Service de Biochimie Hormonologie, APHP, Paris, France.

Cystinuria is a heterogeneous, rare but important cause of inherited kidney stone disease due to mutations in 2 genes: SLC3A1 and SLC7A9. Antenatal hyperechoic colon (HEC) has been reported in some patients as a non-pathological consequence of the intestinal transport defect. We report 83 patients affected by cystinuria: 44 presented prenatally with a HEC (HEC group) and 39 with a classical postnatal form (CC group). Read More

J Obstet Gynaecol 2017 Nov 9;37(8):1085-1086. Epub 2017 Jun 9.

d Department of Medicine, Divisions of Obstetric Medicine and Pulmonary Critical Care Medicine , The Miriam Hospital and Alpert Medical School of Brown University , Providence , RI , USA.

J Pediatr Urol 2017 Oct 20;13(5):509.e1-509.e7. Epub 2017 Apr 20.

Division of Pediatric Urology, Seattle Children's Hospital, Seattle, WA, USA.

Introduction: Early data support the use of medical expulsive therapy (MET) in children. However, little is known regarding use or outcomes associated with MET outside of pediatric-specific practices. Using a national administrative dataset, we sought to characterize utilization patterns of MET as well as assess outcomes associated with MET exposure. Read More

Aust Vet J 2017 May;95(5):174-177

Goulburn Valley Equine Hospital, Congupna, Victoria, Australia.

Case Report: Cystic urolithiasis is the most common form of urolithiasis reported in horses. In contrast to the gelding or stallion, clinical disease is less common in the mare and manual removal techniques are possible because of their shorter, wider urethral anatomy. However, these manual removal techniques can be traumatic and are limited by the size of the urolith. Read More

Can J Urol 2017 Apr;24(2):8770-8772

Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia.

Bilateral obstructing ureteric calculi is a rare cause of acute renal failure. Although urolithiasis in later pregnancy is not uncommon, the development of bilateral obstruction secondary to ureteric calculi in the first trimester is rare and poses difficulty to diagnosis and management. Symptoms of diseases and physiological changes associated with pregnancy can obscure diagnosis of urolithiasis and obstructive uropathy. Read More

World J Urol 2017 Nov 19;35(11):1637-1649. Epub 2017 Apr 19.

2nd Department of Urology, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece.

Purpose: Management of urolithiasis in pregnancy can be challenging for most urologists with diagnostic and treatment dilemma to ensure the best outcome for both mother and fetus. We wanted to review the literature for urolithiasis in pregnancy with a practical management guide for urologists.

Methods: A non-systematic review of literature was carried out for all English language literature using Medline. Read More

World J Urol 2017 Sep 16;35(9):1395-1399. Epub 2017 Mar 16.

Department of Urology, Muljibhai Patel Urological Hospital, Nadiad, India.

Urolithiasis is a significant worldwide source of morbidity, constituting a common urological disease that affects between 10 and 15% of the world population. Recent technological and surgical advances have replaced the need for open surgery with less invasive procedures. The factors which determine the indications for percutaneous nephrolithotomy include stone factors (stone size, stone composition, and stone location), patient factors (habitus and renal anomalies), and failure of other treatment modalities (ESWL and flexible ureteroscopy). Read More

Acta Vet Scand 2017 Mar 14;59(1):16. Epub 2017 Mar 14.

Clinic for Obstetrics, Gynecology and Andrology of Large and Small Animals with Ambulatory Services, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Frankfurter Str. 106, 35392, Giessen, Germany.

Sonography is a convenient, non-invasive diagnostic modality in small ruminants, often used in reproductive management, internal medicine, and surgery. Pregnancy diagnostics and imaging anatomy and pathology of organs, such as neoplasia, are major applications. Urolithiasis is one of the most common causes of death in male sheep and goats, for which sonography is the diagnostic modality of choice. Read More

World J Urol 2017 Sep 7;35(9):1381-1393. Epub 2017 Mar 7.

Western University, London, ON, Canada.

There are several special situations in which urinary lithiasis presents management challenges to the urologist. An in-depth knowledge of the pathophysiology, unique anatomy, and treatment options is crucial in order to maintain good health in these patients. In this review, we summarize the current literature on the management of the following scenarios: bladder stones, stones in bowel disease, during pregnancy, in association with renal anomalies, with skeletal deformities, in urinary diversions, and in children. Read More

J Urol 2017 08 24;198(2):389-393. Epub 2017 Feb 24.

Section of Urology, Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire; Geisel School of Medicine at Dartmouth (SK), Hanover, New Hampshire. Electronic address:

Purpose: Lithogenic urinary changes develop during pregnancy. Such changes may increase stone proclivity thereafter in working and child rearing aged women. However, to our knowledge such an association has not been previously identified. Read More

Urol Ann 2017 Jan-Mar;9(1):32-36

Department of Urology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India.

Aim: Pregnancy is an anatomical and physiological altered state and the presence of various urological problems not only aggravates the disease itself, but also results in unfavourable pregnancy outcome. Aim is to highlight obstetric outcome in pregnant women with urological problems.

Materials And Methods: Longitudinal prospective cohort study conducted in tertiary care hospital, IPGME and R, Kolkata from Jan 2011 to Dec 2012. Read More

J Matern Fetal Neonatal Med 2018 Jan 31;31(2):191-196. Epub 2017 Jan 31.

a Department of Obstetrics and Gynecology , Urology Division, Centre Hospitalier Universitaire de Sherbrooke , Sherbrooke , Québec , Canada.

Objectives: To evaluate the in vitro effect of tamsulosin and nifedipine on the contractility of pregnant rat ureters and to perform quantitative analysis of the pharmacological effects. Medical expulsive therapy (MET) is commonly used to treat urolithiasis. However, this treatment is seldom used in pregnant women since no studies support this practice. Read More

J Reprod Med 2017 Jan-Feb;62(1-2):89-91

BACKGROUND: The cesarean delivery rate continues to rise in the United States. The majority of cesarean deliveries are performed secondary to a previous cesarean delivery. Bladder injury at the time of a repeat cesarean delivery is a known risk. Read More

Am Fam Physician 2016 Oct;94(7):575-576

Urologia 2017 Feb 2;84(1):28-34. Epub 2016 Dec 2.

Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran - Iran.

Background: Extracorporeal shock wave lithotripsy (ESWL) is an important tool for the management of urolithiasis. The effects of shockwaves on tissues are established. The aim of this meta-analysis is to evaluate the microscopic semen characteristics of young men before and after ESWL treatment for lower ureteral calculi. Read More

Turk J Urol 2016 Dec;42(4):290-294

Department of Urology, Dicle University School of Medicine, Diyarbakır, Turkey.

Objective: The aim of this study was to compare the results of urine cultures obtained either from urethral, and percutaneous nephrostomy (PCN) catheters.

Materials And Methods: This study included 328 consecutive patients that underwent PCN at our institution with complicated urinary tract infections (UTIs) between July 2010 and April 2015. Results of urine cultures obtained from the urethral and nephrostomy catheters were compared. Read More

Int J Surg 2016 Dec 2;36(Pt D):688-692. Epub 2016 Nov 2.

U-merge (Urology in Emerging Countries), London, UK. Electronic address:

Urolithiasis in pregnancy is a major health concern and can potentially affect the well-being of both mother and foetus. Management of this condition often entails simultaneous multidisciplinary involvement of obstetrician, radiologist and urologist. Additionally, adverse effects with usage of anaesthesia, radiation, medications and surgery on mother and foetus, limit utilisation of the full armamentarium of diagnostic and therapeutic modalities that are commonly used in non-pregnant women. Read More

Int J Surg 2016 Dec 2;36(Pt D):638-646. Epub 2016 Nov 2.

Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA. Electronic address:

Nephrolithiasis is a common cause of abdominal pain and will affect approximately 1 in 10 people in their lifetime. In the past two decades, there have been several technological advances that have changed the imaging approach to stone diagnosis and follow-up. We present a review of the current imaging evaluation for renal stone disease, and outline how new technology has helped with diagnosis and management. Read More

Emerg Radiol 2017 Feb 10;24(1):81-86. Epub 2016 Sep 10.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, 4150 Clement Street, Building 200, Rm 2A-166, San Francisco, CA, 94121, USA.

Pain resulting from renal and ureteral stones is a common cause for patients presenting in the acute setting. Since the late 1990s, computed tomography (CT) has been the initial imaging method of choice to evaluate patients with suspected ureteral stones; however, concerns regarding both radiation dose and cost-effectiveness have prompted investigations into a different imaging algorithm. Studies utilizing ultrasound have provided evidence indicating that it may be a more appropriate first step, with selective use of CT in selected cases, in the diagnostic work-up. Read More

Minerva Urol Nefrol 2016 Dec 21;68(6):547-559. Epub 2016 Jul 21.

Mayo Clinic, Department of Urology, Rochester, MN, USA -

Ureteroscopy is the treatment of choice for small ureteral or renal calculi and for diagnosis of ureteral abnormalities suspicious for urothelial carcinoma. In certain scenarios ureteroscopy may be used to treat large stones or tumors when other more favorable treatment modalities are not possible. In such situations ureteroscopy can prove to be a challenging procedure. Read More