Abstract
Introduction
The management of stone-related renal colic during pregnancy remains challenging because of diagnostic and therapeutic constraints specific to pregnancy. Current recommendations regarding double-J stent management are mainly based on limited observational data, and real-world practices may differ substantially between centers. This study aimed to evaluate current practices among urologists in France regarding the management of symptomatic urinary stones during pregnancy, with a particular focus on double-J ureteral stents.Materials and methods
A national cross-sectional online survey was conducted among French urologists between January and April 2026 under the supervision of the Urolithiasis Committee of the French Association of Urology (CLAFU). The questionnaire consisted of 22 multiple-choice questions exploring respondent characteristics, double-J stent management practices, complications and therapeutic strategies, and organization of care and guideline adherence. Descriptive statistical analyses were performed.Results
A total of 173 participants completed the survey. Most respondents worked in private institutions (38.7%), university hospitals (28.9%), or regional hospitals (24.3%). The majority of centers managed fewer than 10 pregnant patients with renal colic annually. Obstructive febrile urinary tract infection was the main indication for double-J stent placement (63.6%). Stent replacement practices were heterogeneous, with no systematic replacement reported by 28.9% of respondents and replacement every 6 weeks by 26.6%. Ultrasound follow-up was not routinely performed in 42.8% of centers. During stent placement, fluoroscopy with strict radiation minimization alone was the most commonly used imaging modality (52.0%), followed by ultrasound-only guidance alone (40.5%). Silicone stents were predominantly used (90.8%). More than 65% of respondents reported having already left a double-J stent in place for more than 6 weeks without complications. The most frequently reported complication was urinary tract infection (41.0%). Ureteroscopy during pregnancy was performed in 37.6% of centers, although only 11.6% used ureteroscopy as a first-line treatment strategy. Only 13.9% of respondents reported the existence of a local institutional protocol. Overall, 68.2% of respondents reported being aware of and applying the CLAFU recommendations, while 46.2% considered them suitable for daily practice.Conclusions
Management practices for renal colic during pregnancy vary considerably across French centers, particularly regarding double-J stent replacement intervals and imaging follow-up strategies. Many clinicians reported prolonged stent indwelling without major complications, questioning the systematic need for iterative replacement every 4 to 8 weeks. These findings highlight the need for stronger evidence and more standardized recommendations for the management of symptomatic urinary stones during pregnancy.