Application of Flexible Holmium Laser Sheath in Rigid Ureteroscopy for the Treatment of Impacted Upper Ureteral Stones.

Abstract

By comparing with rigid ureteroscopy (r-URS), we explored the application value of flexible holmium laser sheath combined with r-URS in treating impacted upper ureteral stones. We also verified its effectiveness, safety and economy and investigated its application prospects at community or primary hospitals. From December 2018 to November 2021, 158 patients with impacted upper ureteral stones were selected from Yongchuan Hospital of Chongqing Medical University. Seventy-five patients in the control group were treated with r-URS, and 83 patients in the experimental group were treated with r-URS combined with a flexible holmium laser sheath if necessary. The operation time, postoperative hospital stay, hospitalization expenses, stone clearance rate after r-URS, auxiliary extracorporeal shock wave lithotripsy (ESWL) ratio, auxiliary flexible ureteroscope, the incidence of postoperative complications and the stone clearance rate after one month were observed. The postoperative hospital stay, stone clearance rate after r-URS, the ratio of auxiliary ESWL, the ratio of the auxiliary flexible ureteroscope, and total hospitalization expenses in the experimental group were significantly less than those in the control group (p < 0.05). There was no significant difference in operation time, postoperative complications, and stone clearance rate after one month between the two groups (p > 0.05). r-URS combined with flexible holmium laser sheath in treating impacted upper ureteral stones can improve the stone clearance rate and reduce hospitalization expenses. Therefore, it has a certain application value in community or primary hospitals.