妊娠中に発症し治療に難渋した尿管結石の1例

A case of ureteral stone during pregnancy

　症例は34歳，女性。妊娠4か月目に右尿管結石を発症し，超音波ガイド下に経尿道的尿管砕石術（TUL）と尿管ステント留置術を施行した。その後，急性腎盂腎炎を併発し，再度TULと尿管ステント交換術を施行し，無事出産に至った。妊娠中の尿路結石は，診断・治療に際し各種制限が関係する。胎児へのX線被曝などの影響を十分に考慮したうえで，治療上の有益性が上回る方法のみ選択すべきであると考えられた。

A 34-year-old woman presented at 16 weeks of gesta-tion with right-sided renal colic. Ultrasonography of the abdomen showed right ureteral stone and hydronephro-sis. Transurethral lithotripsy and ureteral stenting using ultrasound were carried out. At 28 weeks of gestation the patient presented again with renal colic at the same side and high fever. Under diagnosis of right ureteral stone accompanied with acute pyelonephritis, transure-thral stent and stone extraction was performed success-fully and the patient delivered a baby at full term. Man-agement of urolithiasis during the period of gestation is troublesome.