UP-03.081 Transureteral Ureterolithotripsy of Ureteral Calculi: Which Is Best, Pneumatic or Holmium Laser Technique?

Abstract

Urinary calculi are important problem in urology. Ureteral stones can cause obstructive uropathy and subsequent deterioration of renal function. Extracorporeal shockwave lithotripsy (SWL) and rigid and flexible ureteroscopy have greatly improved the urologist's ability to treat ureteral calculi. However, the success rate of SWL for impacted ureteral calculi is reportedly low. For stone fragmentation, a variety of lithotripters can be used, including ultrasonic, electrohydraulic, pneumatic and laser lithotriptors. Pneumatic lithotripsy and holmium:YAG lithotripsy have reported favorable outcomes. The Swiss Lithoclast developed in Lausanne, Switzerland, fragments the stones by oscillary movements of metal probe against the stones like a jack hammer. The thermal effect produced by holmium:YAG laser pulses are due to formation of plasma bubble. This bubble at the tip of the fiber connected to the holmium:YAG laser makes it possible to work on stones and soft tissues. Our aim was compare two types of lithotripter: holmium: YAG laser and pneumatic one in transurethral ureterolithotripsy (TUL) for management of ureteral calculi ≥1cm.