Pneumatic Lithotripsy versus Holmium:YAG Laser Lithotripsy for the Treatment of Single Ureteral Stones: A Prospective, Single-Blinded Study

The use of intracorporeal lithotripsy for the management of larger ureteral and intrarenal calculi has dramatically improved. Although the choice of intracorporeal fragmentation is frequently based on the location and composition of the stone to be treated, the experience of the clinician and availability of equipment often dictates this decision. Several different modalities of intracorporeal lithotripsy are currently available. Ultrasonic lithotripsy is mainly used for the fragmentation of large renal calculi during percutaneous nephrolithotripsy procedures. Ultrasound is used rarely via an ureteroscopic approach. Significant advances in laser fibres and power generation systems have propelled laser lithotripsy to the treatment of choice for fragmentation of most ureteral stones. Pneumatic lithotripsy consists of a pneumatically driven piston which will fragment stones by direct contact.

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Evaluation of pneumatic versus holmium:YAG laser lithotripsy for impacted ureteral stones

International Urology and Nephrology ◽

10.1007/s11255-011-9951-8 ◽

2011 ◽

Vol 43 (4) ◽

pp. 989-995 ◽

Cited By ~ 22

Author(s):

Murat Binbay ◽

Abdulkadir Tepeler ◽

Avinash Singh ◽

Tolga Akman ◽

Erdem Tekinaslan ◽

...

Keyword(s):

Laser Lithotripsy ◽

Ureteral Stones ◽

Holmium:Yag Laser

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LITOTRIPSI LASER HOLMIUM YAG UNTUK TERAPI BATU URETER

Indonesian Journal of Urology ◽

10.32421/juri.v15i2.352 ◽

1970 ◽

Vol 15 (2) ◽

Author(s):

Kuncoro Adi ◽

Ferry Safriadi ◽

Suwandi Sugandi ◽

Zulhardi Haroen ◽

Bambang S Noegroho ◽

...

Keyword(s):

Ureteral Stone ◽

Laser System ◽

Intravenous Urography ◽

Laser Lithotripsy ◽

Ureteral Stones ◽

Holmium:Yag Laser ◽

Stone Treatment ◽

The Mean ◽

Age Range

Objective: To assess the efficacy of pulsed holmium:YAG laser lithotripsy for ureteral stone therapy. Material and method: Ninety-one patients (70 males and 21 females) with age range 20 – 76 years underwent 93 ureteroscopic procedures for 101 ureteral stones. A preoperative diagnosis was established by ultrasound scanning and intravenous urography. An 8 F rigid Karl-Storz ureteroscope was used for a holmium:YAG laser (OmniPulse MaxTM 80 watt Holmium Laser System Model 1210-VHP, Trimedyne,Inc. Irvine CA, USA) as energy source for laser lithotripsy. The stone localization was mostly at the lower third of the ureter. The mean stone size was 9,6 mm, mean duration of procedure was 48,1 minutes, and the mean hospital stay was 2,1 days. Results: The overall stone clearance rate was 95,6% with the best results for stones in the middle third of the ureter (100%). At follow up we noted two patients with residual stones and two patients with a perforation of the ureteral wall. Conclusion: The Holmium:YAG laser is effective for ureteral stone treatment with a high success rate. Special attention and care should be afforded in impacted ureteral stones.

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Pneumatic Lithotripsy Versus Laser Lithotripsy for Ureteral Stones

Journal of lasers in medical sciences ◽

10.15171/jlms.2018.42 ◽

2018 ◽

Vol 9 (4) ◽

pp. 233-236 ◽

Cited By ~ 9

Author(s):

Amir Reza Abedi ◽

Mohammad Reza Razzaghi ◽

Farzad Allameh ◽

Fereshte Aliakbari ◽

Morteza FallahKarkan ◽

...

Keyword(s):

Yttrium Aluminum Garnet ◽

Operation Time ◽

Laser Lithotripsy ◽

Ureteral Stones ◽

Pneumatic Lithotripsy ◽

Stone Free Rate ◽

Yttrium Aluminum ◽

Stone Migration ◽

Mean Size ◽

Free Rate

Introduction: Several different modalities are available for ureteral stone fragmentation. From them pneumatic and holmium: yttrium-aluminum-garnet (Ho: YAG) lithotripsy have supportive outcomes. In this study we studied 250 subjects who had ureteroscopic pneumatic lithotripsy (PL) or laser lithotripsy (LL). Methods: Two-hundred fifty patients with ureteral stones underwent ureteroscopic lithotripsy (115 subjects in the PL group, 135 subjects in the LL group) from August 2010 to April 2016. The purpose of this investigation was to evaluate stone-free rate (SFR), mean operation time (MOT), mean hospital stay (MHS), stone migration and complications. Results: Two groups were similar in age, gender, mean size of stones, side of stone, and complications. There was a statistical difference in terms of SFR, stone migration and MHS in favor of the LL group (P ≤ 0.05, P ≤ 0.05 respectively), and MOT in favor of the PL group (P ≤ 0.05). Conclusion: Both the PL and LL techniques were effective and safe for ureteral stones, however a slightly higher SFR was found in the LL group.

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Comparative Study between Pneumatic and Holmium Laser Lithotripsy in Treatment of Ureteric Stones

QJM ◽

10.1093/qjmed/hcab110.008 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mohamed Esmat ◽

Karim Omar Elsaeed ◽

Moataz Bellah Mohamed Adel

Keyword(s):

Operating Time ◽

Laser Lithotripsy ◽

Early Postoperative Period ◽

Holmium Laser ◽

Ureteral Stones ◽

Pneumatic Lithotripsy ◽

Randomized Clinical Study ◽

Holmium Laser Lithotripsy ◽

Group 2 ◽

Group 1

Abstract Objective The aim of this study was to compare the efficacy & safety of holmium laser and pneumatic lithotripsy used in the ureteroscopic treatment of ureteral stones. Materials and Methods A prospective randomized clinical study was done using the data of patients to whom ureteroscopic lithotripsy (URL) was applied for ureter stones in our clinic. Then these patients were separated into 2 groups according to the type of lithotriptor used in stone fragmentation as laser lithotripsy (Group 1) and pneumatic lithotripsy (Group 2). Results Statistically, the two groups were similar in respect of the number of stones, stone burden and the number of double J stents applied intra-operatively. Mean operating time was calculated as 62.9 (±7.69) minutes in Group 1 and 50.98 (±6.63) minutes in Group 2. The mean operating time was found to be higher in group 1 than group 2 (P = 0.000). On postoperative day 1 after the URL, the SFR of Group 1 79.0% found to be significantly high compared to the SFR of Group 2 (64.0%) (P = 0.019), while at postoperative month 1, the SFR of both groups (Group 1 84%, Group 2 80%) was found to be similar (P = 0.462). Conclusions Compared to the pneumatic lithotripter, the Ho: YAG laser seems to have a statistically significant higher SFR in the early postoperative period (1 day), even though there are statistically insignificant success rate (after 1 month) and complications (hematuria, mucosa injury, stone migration, stricture and perforation avulsion).

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Laser Versus Pneumatic Lithotripsy With Semi-Rigid Ureteroscope; A Comparative Randomized Study

Journal of lasers in medical sciences ◽

10.15171/jlms.2019.29 ◽

2019 ◽

Vol 10 (3) ◽

pp. 185-188

Author(s):

Seyed Mohammadreza Rabani ◽

Seyedhossein Rabani ◽

Najmeh Rashidi

Keyword(s):

Randomized Study ◽

Laser Lithotripsy ◽

Ureteral Stones ◽

Female Ratio ◽

Pneumatic Lithotripsy ◽

Extracorporeal Shock Wave ◽

Academic Center ◽

Significant Difference ◽

Group 2 ◽

Group 1

Introduction: Ureteral stones are among the most common disorders in the urologic field. Miniaturization of endoscopic devices in urology and extracorporeal shock wave lithotripsy (ESWL) has revolutionized the management of ureteral stones. The aim of this study was to compare the efficacy and results of laser versus pneumatic lithotripsy (PL) with semi-rigid ureteroscope in a randomized prospective clinical trial in removing stones. Methods: 117 adult patients underwent transurethral lithotripsy (TUL) in a single academic center and by a single surgeon. The patients were randomized in 2 groups: In group 1, 58 patients with ureteral stones underwent ureteroscopy and stone fragmentation was done by Ho: YAG laser lithotripsy (LL) and in group 2, 59 patients underwent PL (Swiss LithoClast) by using the same ureteroscope. Results: Mean age was 41.77 years and 41.1years in group one and 2 respectively (P=0.79), there was no significant difference in male to female ratio and mean stone in both groups. The success rate for stone clearance was 79.31% and 77.96% in group 1 and 2 respectively (P=0.52). No difference between complications was seen in both groups, but the duration of operations was different (significantly lower in group 2). Conclusion: In both techniques, acceptable results were achieved. We have found a significant statistical difference in duration of operation between our results (P=0.001) and similar studies, while this was shorter in the pneumatic group in our study, it was longer in other similar ones. This might be a result of more experience in working with PL in our center.

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