Abstract
ABSTRACT Background: Holmium YAG (yttrium-aluminum-garnet) laser, a comparatively new technique, can clear all types and sizes of stones and is only being used in two institutes of Karachi, Pakistan. The study aimed to compare pneumatic lithoclast and holmium YAG laser, to evaluate stone-free rate (SFR), postoperative complications, operative duration, and effectiveness. Methods: This cross-sectional research included 60 patients with age 16-65 years having ureteric stones, reporting to kidney center, Urology Department, Karachi, Pakistan. CT Scan of Kidneys, Ureter, and Bladder (KUB) were used to record stone size, laterality, and location within the ureter. Patients were divided into two clusters of 30 each, group A (Ho: YAG laser) and group B (pneumatic Lithoclast) having 0.5 to 02 cm of size ureteric stones. An Independent two-sample “t” test was used to assess the difference for the continuous variables. A p-value of ≤0.05 was considered statistically significant. Results: Stone sizes distribution was 1.3±0.3cms and 1.4±0.3cms for A and B groups respectively (p=0.8). The insignificance of the p-value demonstrated no substantial divergence between both groups and stone sizes. Clearance from the proximal ureter was noted 26(84.6%) in group A and 41.7% in group B with (p<0.05). A reduced lithotripsy activation period of 30.8±3.7mins was associated with stone size (p<0.05). Conclusion: Holmium: YAG Laser had better stone-free rate (SFR), with 84% clearance than pneumatic. Improved and effective clearance reduces the risk of residual stones within a lesser time, required for getting back to normal life routines. Keywords: Lasers; Ureteric Stones; Ho: YAG Laser; Pneumatic Lithoclast; Kidney Stones.
Highlights
Renal stones are prevalent worldwide, tormenting as the third most commonly occurring renal disease after Urinary tract infection and prostate problems such as benign prostate hyperplasia, approximately 20% incidence rates have been recorded with higher frequencies in Asian countries like India, Pakistan, Afghanistan, and Nepal
This study aimed to compare the efficacy of pneumatic lithoclast and holmium YAG laser in the treatment of ureteric calculi measuring < 2.0cms and to evaluate Stone-free rate (SFR), postoperative complications, and operative duration
Patients were arranged in equal numbers in two clusters, in group A 30 patients went through Ho: YAG laser for stone fragmentation of ureter, group B participants had pneumatic Lithoclast in 30 patients
Summary
Renal stones are prevalent worldwide, tormenting as the third most commonly occurring renal disease after Urinary tract infection and prostate problems such as benign prostate hyperplasia, approximately 20% incidence rates have been recorded with higher frequencies in Asian countries like India, Pakistan, Afghanistan, and Nepal. Pakistan is known to be geographically situated on the Afro-Asian stone belt, which makes Pakistani population incidence rates higher than neighboring countries. From the list of many procedures, two lithotripters are known as most effective in the present era, an old and trusted Pneumatic lithoclast and a new, modified, and efficient holmium YAG laser[5,6]. Some researchers assessed the mean difference of stone fragmentation time and stone-free rates amid both lithotripters and specified higher fragmentation and reduced lithotripsy period in laser[7,8]. Holmium YAG (yttrium-aluminum-garnet) laser, a comparatively new technique, can clear all types and sizes of stones and is only being used in two institutes of Karachi, Pakistan. The study aimed to compare pneumatic lithoclast and holmium YAG laser, to evaluate stone-free rate (SFR), postoperative complications, operative duration, and effectiveness
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