Trans-Ureteral Ureterolithotripsy of Ureteral Calculi:Which is the Best; Pneumatic or Holmium Laser Technique?
Journal of Lasers in Medical Sciences,
Vol. 2 No. 2 (2011),
28 June 2011
,
Page 59-62
Abstract
INTRODUCTION: Our aim was compare of two types of lithotripter include holmium: YAG laser and pneumatic one in transurethral ureterolithotripsy (TUL) for the management of ureteral calculi ≥1 cm.
METHODS: 112 patients with ureteral calculi more than 1 cm were selected in randomized order for pneumatic or holmium: YAG laser transurethral ureterolithotripsy (56 patients in each group). Ultrasonography and intravenous urography were performed for all patients before surgery. Complete clearance and success was defined as the absence of any fragments on post operation KUB and ultrasonography images.
RESULTS: Success rate was 85.7% in pneumatic group and 100% in holmium: YAG laser group (p =0.003). Stone migration up in the pelvicalyceal system was observed only in 8 cases of pneumatic group. No statically differences were observed in terms of patient’s age, hospital stay, and complications between two groups.
CONCLUSION: According to our experience, for ureteral stone larger than 1 Cm treatment with ureteroscopy and laser lithotripsy is a preferring approach with favorable operation time and hospital admission, and no more significant complication.
- complication
- success rate
- ureter
- ureteral calculi
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References
Lam JS, Greene TD, Gupta M. Treatment of Proximal Ureteral Calculi: Holmium:Yag Laser Ureterolithotripsy Versus Extracorporeal Shock Wave Lithotripsy. J Urol.2002 May;167(5):1972-6.
Lingeman JE, Lifshitz DA, Even AP. Surgical management of urinary lithasis. In: Walsh R, Wein V, editors. Campbell’s Urology. 8th ed (4). Philadelphia: Saunders; 2002;3361-438.
Gulmi FA, Felsen D, Vaughan D. Pathophysiology of urinary tract obstruction. In: Walsh R, Wein V, editors. Campbell’s Urology. 8th ed (4). Philadelphia: Saunders; 2002; P.436
Robert WW, Cadeddu JA, Micali S, Kavoussi LR, Moore RG. Ureteral stricture formation after removal of impacted calculi. J Urol. 1998;159:723.
Geol R, Aron M, Kesarwani PK, Dogra PN, Hemal AK, Gupta NP. Percutaneous antegrade removal of impacted upper-ureteral calculi: Still the treatment of choice in developing countries. J Endourol. 2005;19:5
Drach GW, Dretler S, Fair W, Finlayson B, Gillenwater J, Griffith D, et al. Report of the United States Cooperative Study of Extracorporeal Shock Wave Lithotripsy. J Urol. 1986;135:1127.
Grasso M, Bagley D. A 7.5/8.2 French actively deflectable, flexible ureteroscope: A new device for both diagnostic and therapeutic upper urinary tract endoscopy. Urology. 1994;43:435.
Dretler SP, Keating MA, Riley J. An algorithm for the management of ureteral calculi. J Urol. 1986;136:1190.
Lingeman JE, Shirrell WL, Newman DM, Mosbaugh PG, Steele RE, Woods JR. Management of upper ureteral calculi with extracorporeal shockwave lithotripsy. J Urol. 1987;138:720.
Singal RK, Denstedt JD. Contemporary management of ureteral stones. Urol. Clin. North Am. 1997; 24: 59–70.
Denstedt JD, Eberwein PM, Singh RR. The Swiss Lithoclast: a new device for intracorporeal lithotripsy. J. Urol. 1992; 148: 1088–90.
Denstedt JD, Razvi HA, Rowe E, Grignon DJ, Eberwein PM. Investigation of the tissue effects of a new device for intracorporeal lithotripsy: the Swiss Lithoclast. J. Urol. 1995; 153: 535–7.
Cecchetti W, Zattoni F, Nigro F, Tasca A. Plasma bubble formation induced by Hol: yag laser: An in-vitro study. Urology. 2004; 63: 586-90.
Mueller SC, Wilbert D, Thueroff JW, Alken P. Extracorporeal shock wave lithotripsy of ureteral stones: clinical experience and experimental findings. J Urol. 1986;135:831-4.
Park H, Park M, Park T. Two-year experience with ureteral stones: extracorporeal shockwave lithotripsy v ureteroscopic manipulation. J Endourol. 1998;12:501-4.
Robert M, Bennani A, Guiter J, Averous M, Grasset D. Treatment of 150 ureteric calculi with the Lithoclast. Eur Urol. 1994; 26(3): 212–15.
Vorreuther R, Klotz T, Heidenreich A, Nayal W, Engelmann U. Pneumatic v electrokinetic lithotripsy in treatment of ureteral stones. J Endourol. 1998; 12:233–6.
Vassar GJ, Chan KF, Teichman JM, Glickman RD, Weintraub ST, Pfefer TJ, et al. Holmium:YAG lithotripsy: photothermal mechanism. J Endourol. 1999; 13: 181–90.
Teichman JM, Vassar GJ, Bishoff JT, Bellman GC. Holmium:YAG lithotripsy yields smaller fragments than lithoclast, pulsed dye laser or electrohydraulic lithotripsy. J Urol. 1998;159: 17–23.
Mugiya S, Nagata M, Un-No T, Takayama T, Suzuki K, Fujita K. Endoscopic management of impacted ureteral stones using a small caliber ureteroscope and a laser lithotriptor. J Urol. 2000;164:329-31.
Harmon WJ, Sershon PD, Blute ML, Patterson DE, Segura JW Ureteroscopy: current practice and long-term complications. J Urol. 1997;157:28-32.
Karami H, Arbab AH, Hossini SJ, Razzaghi MR, Simaei NR. Impacted upper-ureteral calculi >1 cm: blind access and totally tubeless percutaneous antegrade removal or retrograde approach? J Endourol. 2006;20:616-9.
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