A prospective evaluation of high- and low-power holmium laser settings for transurethral lithotripsy in the management of adults with urethral stone

Abstract

Backgrounds To compare the effectiveness and safety of high-power (100 W) vs. low-power (20 W) laser settings for transurethral laser lithotripsy in the treatment of urethral stones. Methods The trial was open to all patients scheduled for transurethral holmium laser lithotripsy who had urethral stones with the maximal diameter. Either the low-power laser setting or the high-power laser setting was applied to every substitute patient. Using IBM SPSS Statistics 24, we compared the treatment groups' operational times, intraoperative/postoperative problems (up to 1 year), and stone-free rates. Welch tests were used to compare continuous data across treatment groups, whereas Fisher's exact or Chi-square tests were used to evaluate categorical variables. Statistical significance was defined as a p value 0.05. Results Two hundred seven people were hired as a result. Both groups' preoperative data and mean bladder stone sizes were similar. When compared to the low-power cohort, the procedure took much less time—42.6111.74 min as opposed to 78.5625.91 min (p = 0.025)—and the ablation rate was significantly higher in the high-power cohort. In neither group were there any substantial intraoperative issues. High power group considerably outperformed low power group in terms of OABSS score and IPSS. According to results of uni- and multivariate logistic regression, the position of the ureteral stone significantly affects how well the therapy works. Conclusion When treating urethral stones, a high-power laser setting of up to 100 W significantly reduces the length of the procedure without increasing the risk of complications.