A Comparative Study Between Pneumatic and Laser Lithotripsy for Ureteroscopic Extraction of Upper Ureteric Calculus: A Prospective Study

Document Type : Original Article

Authors

1 Department of Urology, Kobry El Koba Military Hospital, Ministry of Defense, Cairo, Egypt

2 Department of Urology, Faculty of Medicine [for girls], Al-Azhar University, Cairo, Egypt

Abstract

Background: The daily practice of urology includes managing patients with urolithiasis, and there are various methods for managing ureteral calculi. There are many techniques for fragmenting stones. The holmium: yttrium-aluminum-garnet [Ho: YAG] laser is often utilized in stone disintegration procedures.
Aim of the work: This research compares the effectiveness of laser and pneumatic lithotripsy in treating patients with upper ureteric calculi regarding the percentage of patients who remain stone-free, hospital stays, surgical times, and complications.
Patients and methods: Sixty individuals with upper ureteric calculus participated in this prospective comparative analysis. From February 2021 to March 2022, the patients were randomly divided into two groups [Laser Lithotripsy and Pneumatic Lithotripsy]. The main goals of both treatments were to break the stone into pieces smaller than 3 mm, which was confirmed by an X-ray [KUB] on the first post-operative day.
Results: The study's eligibility criteria were met by 60 individuals with upper ureteric stones [30 in the pneumatic group and 30 in the laser group]. In laser lithotripsy, the immediately stone-free rate was 93.3 percent, while in pneumatic lithotripsy, it was 70.0 percent [p value 0.059]. Proximal migration was 6.7% in Laser Lithotripsy and 26.6% in Pneumatic Lithotripsy [p > 0.038]. Pneumatic lithotripsy had a substantially longer operating time than laser lithotripsy [27.83±6.11 min vs. 24.47±5.08 min; p=0.024]. There were no statistically substantial variations between the two groups regarding the patients' age, sex, stone size, length of hospitalization, and complications.
Conclusion: Laser and pneumatic lithotripsy are safe and effective in the treatment of upper ureteric stone with few minor complications; however, laser lithotripsy has a better stone free rate, less operative time, less fluid irrigated and less upward stone migration than pneumatic lithotripsy.

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