Retrospective Analysis of Ureteral Stricture Incidence between Ureteroscopic Holmium Laser and Ureteroscopic Pneumatic Lithotripsy

One of the most effective methods of treatment of ureteral concretions is ureteroscopy with contact lithotripsy. The study analyzed the results of treatment of 96 patients with urolithiasis they were as follows: 44 patients underwent laser ureterolithotripsy, 52 persons had an open ureterolithotomy. When comparing different treatments for patients with ureterolithiasis, it has been found that the average duration of surgery when performing laser ureterolithotripsy was shorter and averaged 53 minutes. As for open ureterolithotomy it lasted in average 102 minutes. The average length of patients staying in clinic when performing laser ureterolithotripsy in average was 2.5 days, during open ureterolithotomy that index was 20 days. This is a significant advantage of endoscopic treatment of ureterolithiasis versus an open surgery (especially when a holmium laser is used in lithotripsy). By using endoscopic methods of treatment of ureteral concretions instead of an open surgery (ureterolithotomy), it has been possible to reduce the in−patient staying 8 times. Lithotripsy with a holmium laser occurred to be an effective method of destroying the ureteral concretions of any mineral composition, if the dimensions of these calculi did not exceed 2 cm. It should be emphasized that under these conditions, the localization of a stone and the duration of its stay in the ureter are also not important. In addition, the use of a holmium laser minimizes an injury to the ureter wall. The advantages of lithotripsy when it used with a holmium laser consist in its high efficiency in destruction of solid fixed and the ingrown stones. In case of combination of both a stone and ureteral stricture and in the presence of ligature calculi, the treatment with a holmium laser is also prescribed. Key words: ureterolithiasis, laser ureterolithotripsy, open ureterolithotomy, holmium laser.

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Comparison of Holmium Laser and Pneumatic Lithotripsy in Managing Upper-Ureteral Stones

Journal of Endourology ◽

10.1089/end.2006.0350 ◽

2007 ◽

Vol 21 (12) ◽

pp. 1425-1428 ◽

Cited By ~ 33

Author(s):

Shivadeo S. Bapat ◽

Ketan V. Pai ◽

Satyajeet S. Purnapatre ◽

Pushkaraj B. Yadav ◽

Abhijit S. Padye

Keyword(s):

Holmium Laser ◽

Ureteral Stones ◽

Pneumatic Lithotripsy

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Outcomes of Pneumatic Lithotripsy Versus Holmium Laser-Assisted Lithotripsy With Sialendoscopy in Management of Submandibular Sialolithiasis

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000006607 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Suleyman Ozdemir

Keyword(s):

Holmium Laser ◽

Pneumatic Lithotripsy

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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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A Comparative Study between Holmium Laser, Pneumatic Lithotripsy and Shock Pulse in Terms of Efficacy and Safety in Percutaneous Nephrolithotomy (PCNL) : A Prospective Randomised Study.

Journal of Endoluminal Endourology ◽

10.22374/jeleu.v3i1.75 ◽

2020 ◽

Vol 3 (1) ◽

pp. e1-e8

Author(s):

Rajeev T P ◽

Sarbartha Kumar Pratihar ◽

Debanga Sarma ◽

Saumar Jyoti Baruah ◽

Sasanka Kumar Barua ◽

...

Keyword(s):

Success Rate ◽

Holmium Laser ◽

Shock Pulse ◽

Efficacy And Safety ◽

Stone Clearance ◽

Pneumatic Lithotripsy ◽

Stone Fragmentation ◽

Stone Free Rate ◽

Significant Difference ◽

Free Rate

Background and ObjectivesPercutaneous nephrolithotomy (PCNL) occupies an essential place in the treatment of upper urinary tract calculi. PCNL also accomplishes higher stone-free rates and requires fewer auxiliary procedures than shock wave lithotripsy (SWL) and ureterorenoscopy (URS) for renal stones between 1–2 cm. There are different intracorporeal lithotripter devices available. This study aims to compare the efficacy and safety of holmium laser, pneumatic lithotripsy and Shock Pulse in PCNL. Materials and MethodsA prospective randomized study was performed in Gauhati Medical College & Hospital, Guwahati, Assam, India, between October 2016 to November 2018. Patients of renal calculi and upper ureteric calculi less than or equal to 2.5cms and functioning kidney on the ipsilateral side were included. 300 patients were randomized according to a random number generator. In the holmium laser, pneumatic and Shock Pulse groups’ number of patients was 96, 102, 102 respectively. Stone disintegration time (SDT), stone-free rate, failure rate, success rate, irrigant used, mean hematocrit drop were evaluated. Statistical analysis was done to compare and predict any significant difference. ResultsPatients were divided into groups depending on the lithotripter used: group A (n=96), group B (n=102), group C (n=102) were holmium laser, pneumatic lithotripsy, and Shock Pulse respectively. No significant difference in stone location (p=0.785),Hounsfield unit (p=0.115),complication rates between the groups. Stone free rate in laser, pneumatic lithotripter, and Shock Pulse were 81.25%, 67.65%, 82.35% (highest in Shock Pulse and lowest in the Pneumatic group) and failure rate were 6.25%, 14.7%, 5.89% respectively. A significant difference was found in terms of stone-free, success rate, clinically insignificant residual fragments(CIRF)and failure rates between the groups(p<0.001). Irrigant requirement (litre/mm3) between the groups is statistically significant (p<0.001) with the highest in Shock Pulse and lowest in the Pneumatic group. Mean hematocrit drop: 4.19%, 4.20%, 5.46% in Laser, Pneumatic and Shock Pulse respectively. No significant difference between Laser and Pneumatic group (p=0.907), but in Shock Pulse group it is significantly higher. (p< 0.001) ConclusionEfficacy of energy sources used in PCNL for stone fragmentation vary in terms of stone clearance, failure rates, SDT, irrigant requirement and mean hematocrit drop. In our study, we found stone clearance signifi-cantly higher in Shock Pulse than Pneumatic and Laser groups. Stone fragmentation volume per unit time highest in Shock Pulse and lowest in Laser. Irrigant requirement highest in Shock Pulse group and compa-rable between Laser and Pneumatic group. The higher irrigant requirement in the Shock Pulse group may be the cause for higher hematocrit drop in this group. Complications between the groups are comparable.

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