Challenges on percutaneous nephrolithotomy in pregnancy: Supine position approach through ultrasound guidance
A 24-year-old female patient, in her 22th week of pregnancy, presented with severe flank pain secondary to a 2.7 cm urinary stone located in the right renal pelvis that was detected by US []. Despite attempts at conservative management, with optimal analgesic treatment, a retrograde placement of a ureteral stent was necessary due to intractable pain []. However, 1 week later, the patient returned with flank pain refractory to analgesics, when she was submitted to ureteroscopy, but with no success.\nPNL was performed with US guidance (without fluoroscopy) and in a supine position [Figure and ]. Fast and safe stone fragmentation through pneumatic energy and removal was possible [Figure and ]. The patient was released from the hospital on the first postoperative day with no tube and pregnancy curse and labor occurred with no complications.