Comparison of Stone Retrieval Basket, Stone Cone and Holmium Laser: Which One Is Better in Retropulsion and Stone-Free Status for Patients with Upper Ureteral Calculi?
Journal of Lasers in Medical Sciences,
Vol. 10 No. 3 (2019),
6 July 2019
,
Page 179-184
Abstract
Introduction: Transurethral lithotripsy (TUL) is an appropriate treatment for ureteral stones and is usually used for stones in the middle and lower part of the ureter. Different devices such as Holmium laser, stone basket and stone cone exist to prevent any fragments from retropulsion during TUL. The present study aims to compare the advantages and disadvantages of the Holmium laser, stone basket and stone cone.
Methods: A retrospective study was conducted from September 2016 to January 2018 comparing various TUL methods in 88 subjects with proximal ureteral calculi. The study participants were devided into four matched groups. The first one included 20 patients undergoing TUL with no device (Group 1), the second group included 22 patients undergoing TUL while using the stone retrieval basket, the third group included 18 patients undergoing TUL while utilizing the stone cone and the fourth group included 28 patients undergoing TUL while using Hol-YAG laser.
Results: A residual stone ≥ 3 mm was recorded in 15.9% of the patients. stone free rate were seen in 100%, 90.9, 83.3%and 55% in Holmium laser group, retrieval basket group, stone cone group and no device group respectively(p:0.001). Lowest rate of surgery complications including ureteral perforation, Post-operative fever and mucosal damage between 4 groups (p: 0.003) and highest time of surgery (p: 0.001) belong to laser group. If we want to ignore the laser group, success rate for lithotripsy was better in both groups with stone retrieval device compared to the no device group, but no advantage existed between stone basket and stone cone.
Conclusion:We can safely conclude that laser significantly help to prevent stone migration during TUL. If we want to ignore the laser group, success rate for lithotripsy was significantly better in both groups with stone retrieval device compared to the no device group, but no advantage existed between stone basket and stone cone.
- Stone cone
- Stone retrieval basket
- Transurethral lithotripsy
- Ureteral calculi
- Ureteral stone
- Lithoclast lithotripter
- Holmium-YAG Laser
How to Cite
References
Pardalidis NP, Papatsoris AG, Kosmaoglou EV. Prevention of retrograde calculus migration with the Stone Cone. Urol Res. 2005;33(1):61-64. doi:10.1007/s00240-004-0453-3
Abedi A, Razzaghi MR, Allameh F, Aliakbari M, Ranjbar A, Fallah Karkan M. Pneumatic Lithotripsy Versus Laser Lithotripsy for Ureteral Stones. J Lasers Med Sci. 2018;9(4):233-236. doi:10.15171/jlms.2018.42
Fallah Karkan M, Ghiasy S, Ranjbar A, Javanmard B. Evaluation of 200 Mm, 365 Mm and 500 Mm Fibers of Ho: YAG Laser in Transurethral Lithotripsy of Ureteral: A Randomize Control Trial. J Lasers Med Sci. 2018;9(1):69-72. doi:10.15171/jlms.2018.14
Elashry OM, Tawfik AM. Preventing stone retropulsion during intracorporeal lithotripsy. Nat Rev Urol. 2012;9(12):691-698. doi:10.1038/nrurol.2012.204
Shigemura K, Yasufuku T, Yamashita M, Arakawa S, Fujisawa M. Efficacy of combining flexible and rigid ureteroscopy for transurethral lithotripsy. Kobe J Med Sci. 2010;56(1):E24-28.
Abedi AR, Allameh F, Razzaghi MR, et al. The Efficacy and Safety of Laser Lithotripsy in Pregnancy. J Lasers Med Sci. 2017;8(2):84-87. doi:10.15171/jlms.2017.15
Rabani SM, Moosavizadeh A. Management of large proximal ureteral stones: a comparative clinical trial between transureteral lithotripsy (TUL) and shock wave lithotripsy (SWL). Nephrourol Mon. 2012;4(3):556-559. doi:10.5812/numonthly.3936
Razzaghi MR, Fallah Karkan M, Ghiasy S, Javanmard B. Laser application in iran urology: a narrative review. J Lasers Med Sci. 2018;9(1):1-6. doi:10.15171/jlms.2018.01
Gonen M, Cenker A, Istanbulluoglu O, Ozkardes H. Efficacy of dretler stone cone in the treatment of ureteral stones with pneumatic lithotripsy. Urol Int. 2006;76(2):159- 162. doi:10.1159/000090881
Sun Y, Wang L, Liao G, et al. Pneumatic lithotripsy versus laser lithotripsy in the endoscopic treatment of ureteral calculi. J Endourol. 2001;15(6):587-590. doi:10.1089/089277901750426346
Marguet CG, Sung JC, Springhart WP, et al. In vitro comparison of stone retropulsion and fragmentation of the frequency doubled, double pulse nd:yag laser and the holmium:yag laser. J Urol. 2005;173(5):1797-1800. doi:10.1097/01.ju.0000154341.08206.69
Farahat YA, Elbahnasy AE, Elashry OM. A randomized prospective controlled study for assessment of different ureteral occlusion devices in prevention of stone migration during pneumatic lithotripsy. Urology. 2011;77(1):30-35. doi:10.1016/j.urology.2010.05.063
Kressel K, Hoffmann H, Butz M. Long-term experience with transurethral rigid ureteroscopy as a complementary method to extracorporeal shockwave lithotripsy. Urol Int. 1992;48(1):76-80. doi:10.1159/000282301
Desai MR, Patel SB, Desai MM, et al. The Dretler stone
cone: a device to prevent ureteral stone migration-the initial clinical experience. J Urol. 2002;167(5):1985-1988.
Gupta PK. Is the holmium:YAG laser the best intracorporeal lithotripter for the ureter? A 3-year retrospective study. J Endourol. 2007;21(3):305-309. doi:10.1089/end.2006.0247
Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187-196. doi:10.1097/SLA.0b013e3181b13ca2
Lopez M, Hoppe B. History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol. 2010;25(1):49-59. doi:10.1007/s00467-008-0960-5
Knispel HH, Klan R, Heicappell R, Miller K. Pneumatic lithotripsy applied through deflected working channel of miniureteroscope: results in 143 patients. J Endourol.1998;12(6):513-515. doi:10.1089/end.1998.12.513
Dretler SP. The stone cone: a new generation of basketry. J Urol. 2001;165(5):1593-1596.
Maislos SD, Volpe M, Albert PS, Raboy A. Efficacy of the Stone Cone for treatment of proximal ureteral stones. J Endourol. 2004;18(9):862-864. doi:10.1089/ end.2004.18.862
Cindolo L, Castellan P, Primiceri G, et al. Life-threatening complications after ureteroscopy for urinary stones: survey and systematic literature review. Minerva Urol Nefrol. 2017;69(5):421-431. doi:10.23736/s0393-2249.17.02787-4
Fallah Karkan M, Razzaghi MR, Javanmard B, Tayyebiazar A, Ghiasy S, Montazeri S. Holmium: YAG Laser Incision of Bladder Neck Contracture Following Radical Retropubic Prostatectomy. Nephrourol Mon. 2019;11(1):e88677. doi:10.5812/numonthly.88677
Fallah Karkan M, Razzaghi MR, Karami H, Ghiasy S, Tayyebiazar A, Javanmard B. Experience of 138 transurethral urethrotomy with holmium: YAG laser. J Lasers Med Sci. 2019;10(2):104-107. doi:10.15171/ jlms.2019.17
Ghiasy S, Fallah Karkan M, Razzaghi MR, Ranjbar A, Rahavian A, Javanmard B. Is Holmium Laser anAppropriate Modality to Treat Genital Warts? J Lasers Med Sci. 2018;10(1):70-74. doi:10.15171/jlms.2019.11
Javanmard B, Fallah Karkan M, Razzaghi M, Ghiasy S, Ranjbar A, Rahavian A. Surgical management of vesical stones in children: a comparison between open cystolithotomy, percutaneous cystolithotomy and
transurethral cystolithotripsy with holmium-YAG Laser. J Lasers Med Sci. 2018;9(3):183-187. doi:10.15171/ jlms.2018.33
Lee J, Gianduzzo TR. Advances in laser technologyin urology. Urol Clin North Am. 2009;36(2):189-198. doi:10.1016/j.ucl.2009.02.004
Geavlete P, Multescu R, Georgescu D. Flexible ureteroscopic approach in upper urinary tract pathology. Chirurgia (Bucur). 2006;101(5):497-503.
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(1):17-23.
- Abstract Viewed: 434 times
- PDF Downloaded: 182 times