A retrospective observational study compared the efficacy of pneumatic and holmium laser ureteroscopic lithotripsy for treatment of ureteral stones

Abstract

Purpose: To compare the efficacy and complications of holmium laser lithotripters and pneumatic lithotripters, the two most commonly used lithotripters in the endoscopic treatment of ureteral stones, at all ureteral levels. Material and method: Retrospective data on 510 patients who had ureterorenoscopic lithotripsy performed by a single surgeon between January 2018 and 2021 were studied. Patients were divided into two groups: those who received a holmium laser lithotripter and those who received a pneumatic lithotripter. Demographic information, stone-free rates, double-j (JJ) stent usage, JJ stent removal time, type of anesthesia, operation time, hospital stay, and complication rates were all examined. Results: The patient numbers in the holmium laser and pneumatic groups were 265 and 245, respectively. The overall success rate in group 1 was found to be significantly higher than in group 2 (98.5 percent vs 93.9 percent; p=0.006). Group 1 had a significantly higher success rate in proximal ureteral stones (94.4 percent vs 68.9 percent; p=0.001). Patients in group 1 had a significantly higher rate of not using any ureteral stent (29.8 percent vs 17.6 percent; p<0.001). There was no difference between the two groups in terms of mid-ureter and distal ureter stones, anesthesia type, operation time, hospital stay, JJ stent removal time, and complications. Conclusion: For ureteral stones, ureterorenoscopic lithotripsy is the chosen therapeutic approach. The location of the stone in the ureter as well as the type of lithotripters used can have an impact on the outcome. Because of its great efficiency and lack of need for ureteral stents, holmium laser lithotripsy may be preferred for the treatment of proximal ureteral stones.