Ureteroscopic Pneumatic Lithotripsy: Is the Location of the Stone Important in Decision Making? Analysis of 1296 Patients

Abstract

To evaluate the efficacy and complications of pneumatic lithotripsy (PL) in the treatment of ureteral stones in different locations. From February 2001 to October 2006, a total of 1296 patients underwent PL for treatment of ureteral stones. Of these patients, 471 (36.4%) were women and 825 (63.6%) were men, with a mean age of 37.3 years (range 19-71 years). In 203 (15.6%) of these patients, treatment was performed secondarily after stone disease was refractory to extracorporeal shockwave lithotripty. All patients were evaluated by plain radiographs for the presence of stones on the first day and the sixth week postoperatively. Follow-up studies included ultrasonography and/or excretory urography. The overall stone-free rate was 96.2%. According to the location of the stones, the success rate of pneumatic lithotripsy for upper, middle, and lower ureteral stones was 90.5%, 93.1%, and 98.1%, respectively (P < 0.05). For patients with calculi < or =10 mm and >10 mm in size, the stone-free rate after ureteroscopic lithotripsy was 97.6% (896 of 918) and 91.2% (351 of 378), respectively (P < 0.05). The most common complications were postoperative fever (5.3%), small mucosal lesions without leakage (3.6%), and stone migration (3.4%). Ureteroscopic pneumatic lithotripsy is a safe and effective treatment with minimal morbidity in the treatment of ureteral stones in all locations.