Combination of URL and MPCNL with the Frequency - doubled - double Pulse Nd:YAG neodymium Laser in the treatment of ureteral calculi and renal stone after ESWL

Abstract

Objectives To evaluate the efficacy and safety of Ureteroscope Recessive Lithotrity (URL) combined with Minimally Invasive Percutaneous Nephrolithotomy (MPCNL) using the U - 100 Frequency - doubled - double Pulse Nd:YAG neodymium laser in the treatment of the simultaneous ipsilateral renal and ureteral calculi after extracorporeal shock wave lithotripsy (ESWL).Methods 26 cases of ipsilateral renal and ureteral calculi treated with ESWL unsuccessfully were managed by URL with the U - 100 Frequency - doubled - double Pulse Nd:YAG neodymium laser first.The residual calculi in the renal pelvic were cleared by MPCNL simultaneously.The mean operative time,estimated blood loss,residual stone rate and perioperative complication were evaluated.Results 26 patients were successfully established a percutaneous puncture channel.The stone - free rate after phase Ⅰ operation was 76.9％ (20/26).Phase Ⅱ lithotripsy was performed in 1 case.Three cases with residual stones of 0.5 ～ 1.2 cm received adjuvant extracorporeal shock wave lithotripsy while 2 cases with stones less than 0.4 cm discharged stones completely after conservative therapy.The average operative time was 95 min.The average blood loss was 80 ml.The mean postoperative hospital stay was 7.5 days.Conclusions Ureteroscope Recessive Lithotritycombined with Minimally Invasive Percutaneous Nephrolithotomy using U - 100 Frequency - doubled - double Pulse Nd:YAG laser is an alternative for the treatment of ipsilateral renal and ureteral calculi after unsuccessful extracorporeal shock wave lithotripsy,with the advantage of shortened operation time,increased stone clearance rate,minimal ureteral injuries and handling the renal stones in one stage. Key words: Ureteral Calculi; Lithotripsy; Laser