Does a retropulsion prevention device equalize the surgical success of Ho:YAG laser and pneumatic lithotripters for upper ureteral stones? A prospective randomized study.

Abstract

To establish if a retropulsion prevention device for ureteral stones equalizes surgical success and push-back rates of Ho:YAG laser and pneumatic lithotripters for upper ureteral stones. Patients with upper ureteral stones (n=267) were treated endoscopically at the Department of Urology between April 2014 and December 2015. Patients were randomly assigned to pneumatic and Ho:YAG laser lithotripters as group-1 and group-2, respectively. Lithotripsy was performed with Stone ConeTM in both groups. The surgical success rate on the first postoperative day was 81.5% (n=106) and 90.6% (n=116) for group-1 and group-2, respectively, and the difference between the groups was statistically significant (p<0.05). The relation between stone size and surgical success was statistically significant for both groups (p<0.01). Surgical success for the stones closer than 2cm to the UPJ was 23.1% for the pneumatic group versus 64% for the laser group (p<0.01). Lithotripsy time was significantly longer in group-2 (16.48±4.74min) than group-1 (12.24±3.95min) (p<0.01). Ho:YAG laser lithotripsy is more successful than pneumatic lithotripsy for upper ureteral stones and a retropulsion prevention device does not equalize the surgical success of Ho:YAG laser and pneumatic lithotripters for upper ureteral stones on the first postoperative day and one month after surgery. Although the success rate of the first month after surgery is higher in group-2, the difference is not statistically significant.