A comparison of efficacies of holmium YAG laser, and pneumatic lithotripsy in the endoscopic treatment of ureteral stones

Abstract

Objective: We aimed to compare the effectiveness of holmium YAG laser and pneumatic lithotripsy in the treatment of ureteral stones. Material and methods:A total of 216 patients who had established indications of ureteroscopy between November 2011 and June 2012 were included in this study. Patients' files were retrospectively reviewed by dividing cases as groups that underwent pneumatic (PL) or laser lithotripsy (LL) procedures. Age, sex, stone burden and localization, duration of follow-up, operative times were evaluated. Stone-free rates were evaluated by ureteroscopical examination, postoperative scout films and ultrasonography.Results: Group PL consisted of 109 and group LL of 107 patients. Median age was 43.93±15.94 years in Group PL and 46.15±14.54 years in Group LL. Male to female ratio, stone burden and localization were similar for both groups. Overall success rate was 89.9% in Group PL and 87.9% in Group LL, respectively (p<0.791). With the aid of additional procedures, success rate was 100% for both groups at the end of the first month. Groups were not different as for operative time, rate of insertion of an ureteral catheter and its removal time. Hospitalization period was apparently somewhat shorter in Group LL (p= 0.00). Conclusion:Pneumatic lithotripsy can be as efficacious as laser lithotripsy and be used safely in the endoscopic management of ureteral stone. In comparison of both methods, we detected no differences as to operative time, success of operation and the time to removal of the catheter, however, hospitalization period was shorter in Group LL.

Comparison of mean operative time in patients undergoing Ho: YAG laser lithotripsy and pneumatic lithotripsy in ureterorenoscopy for ureteric calculus

“…Although MOT in both groups was found similar (39.6 ± 11.9 vs37.2 ± 13.0, p< 0.07), the stone free rate was better in LL group. Studies conducted by Degirmenci et al 19 , Abedi AR et al 20 and Razzaghi et al 21 22 Baseline characteristics of all these above mentioned studies are comparable to our data. In the current study, in patients having proximal and lower ureteric stones, the MOT was significantly different between LL & PL group (p < 0.05).…”

Comparative evaluation of intracorporeal lithotripsy techniques during ureteroscopy: a clinical experience

“…Both Ho:YAG laser and pneumatic are the commonly used energy sources during ureteroscopic surgery for the treatment of ureteral stones now a days. 9 Still different studies have variable conclusions for these best available methods so this retrospective study was planned to compare both the procedures.…”

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

“…They also mentioned that LL was more expensive than PL and these findings were in accordant to ours. 19 In another study about the application of both of these technologies in renal and ureteral stones in pediatric age groups, Marcin et al concluded that Ho: YAG laser reduced the operation time and increased the efficacy of treatment, especially in renal calculi in comparison to LL. 20 Yin et al in their meta-analysis found that Ho: YAG LL had significant superiority in comparison to PL in terms of early stone-free rate, delayed stone-free rate, shorter operative time and lower stone migration rate, but not yet in the postoperative hematuria rate and the ureteral perforation rate.…”