Method Of Lithotripsy Research Articles

Clinical Observation of UreTron Single-Probe Ultrasonic Intracorporeal Lithotripter for Ureteral Calculi.

ObjectiveThe present study aimed to observe and discuss the effectiveness and safety of the UreTron single-probe ultrasonic intracorporeal lithotripter in ureteroscopic lithotripsy.MethodsThe clinical data of patients with unilateral solitary ureteral calculi treated with ureteroscopic lithotripsy who were hospitalized at the Department of Urology (West District) of Beijing Chaoyang Hospital between March 2016 and August 2020 were selected for retrospective analysis. The patients were divided into the UreTron group (group U) and holmium laser group (group H) according to the lithotripsy method adopted. The operation duration, length of hospital stay, stone clearance rate, proportion of patients requiring flexible ureteroscopy-assisted lithotripsy, and complications were compared between the groups.ResultsThere was no statistical difference between the groups in terms of the general characteristics, operation duration, or length of hospital stay (P > 0.05). Regarding the stone clearance rate (group U=93.5%; group H=75%), proportion of patients requiring flexible ureteroscopy-assisted lithotripsy (group U=6.5%; group H=27.8%), and incidence of surgical complications (group U=1 case; group H=9 cases), group U was superior to group H, and the differences between the groups were statistically significant (P < 0.05). However, the differences in other complications (cardiocerebral complications and lower extremity thrombosis) were not statistically significant between the groups (P > 0.05).ConclusionThe UreTron system is a new lithotripsy apparatus that is safe and effective for ureteroscopic lithotripsy and has certain advantages in terms of the stone clearance rate, proportion of patients requiring flexible ureteroscopy-assisted lithotripsy, and surgical complications, making it worthy of clinical application.

Controlled Fragmentation of Urinary Stones as a Method of Preventing Inflammatory Infections in the Treatment of Urolithiasis (Experience in Successful Clinical Use).

The introduction of technologically advanced methods of lithotripsy into medical practice changes the nature of postoperative complications. Among them, the main complications are inflammatory infections. This largely determines the search for new, improved methods of stone fragmentation avoiding small stone fragments and dissemination of the pelvicalyceal system of the kidney with stone-associated infection. The authors have developed a method for controlled stone fragmentation using a continuous-wave diode laser with a hot-spot effect at the optical fiber end.The aim of the study was to evaluate the efficacy of controlled urinary stone fragmentation using a continuous-wave diode laser with a highly heated distal end of the optical fiber light guide as a method of preventing inflammatory infections in clinical practice.Materials and MethodsWe analyzed 1666 case histories of urolithiasis patients who underwent percutaneous nephrolithotripsy/ nephrolithoextraction and contact ureterolithotripsy/ureteroextraction, we also performed a prospective analysis of complications based on the Clavien–Dindo classification in 90 patients who underwent fine fragmentation of stones with various lithotripters: ultrasonic, pneumatic, and holmium laser. The method of controlled stone fragmentation by a diode laser with a hot-spot effect was tested on postoperative samples of 26 renal calculi. For the first time in clinical practice, this method was tested in the bladder cavity (n=10).ResultsIn the percutaneous nephrolithotripsy group, postoperative infectious and inflammatory complications occurred in 34.1% of cases, in the percutaneous nephrolithoextraction group — in 24.6%, in the contact ureterolithotripsy group — in 7.8%, in the ureterolithoextraction group — in 2.5%. The analysis made it possible to identify factors promoting the development of infectious and inflammatory complications. For the first time in clinical practice, there were successfully performed ten operations of stone fragmentation using a continuous-wave diode laser with a hot-spot effect. Controlled coarse fragmentation of stones providing the possibility to reduce the number of infectious and inflammatory complications was performed in the bladder as a model for testing the method.ConclusionThe method of laser-induced controlled coarse fragmentation of stones with a hot-spot effect, developed and tested in clinical practice, is promising for the prevention of infectious and inflammatory complications in patients with potentially infected stones since their fine fragmentation and, consequently, spread of stone-associated toxins and microflora within the urinary system is avoided.

A Novel Approach for the Treatment of Sialolithiasis that Preserves Salivary Duct Anatomy.

The sialendoscopy era in the treatment of salivary gland stones has reduced the use of classical surgical methods. However, the miniature ducts and tools may cause difficulties in removing large sialoliths. Therefore, invasive combined oral surgeries or gland resection may be considered. We searched for the most suitable method in order to stay in line with the minimally invasive approach that preserves the ductus anatomy, and that can reduce the surgical fears of patients. The study included 84 cases (23 parotid and 61 submandibular) in whom stones were fragmented by pneumatic lithotripsy and removed between January 2015 and January 2020. The parotid cases comprised 7 females and 16 males, and the submandibular cases comprised 25 females and 36 males. Intraductal lithotripsy was performed using pneumatic lithotripter. This study has fourth level of evidence. Based on total number of cases (n = 84), success rate was 67/84 (79.7%) immediately after sialendoscopy, and overall success rate was 77/84 (91.6%). Based on number of stones treated (n = 111), our immediate success rate was 94/111 (84.6%), and overall success rate was 104/111 (93.7%). The success criteria were complete removal of the stone and fragments in a single sialendoscopy procedure and resolution of symptoms. We successfully treated salivary gland stones, including L3b stones, in our patient cohort with sialendoscopy combined with pneumatic lithotripsy. The lithotripsy method that we have adapted seems to be more useful and cost-effective compared to its alternatives. We were also able to preserve the ductus anatomy and relieve patients' concerns.Level of Evidence: Level IV.

Advanced ureteroscopic techniques for the management of kidney stones.

Recent years witnessed significant changes in the endourological management of renal tones because of the development of new, more advanced instruments. Retrograde intrarenal surgery (RIRS) has gained particular advantage from such technological progress and now tends to be considered the gold standard treatment for uncomplicated less than 20 mm renal stones. Using a step-by-step approach, this review aims to highlight current achievements but also unsolved problems in RIRS. Several technical details of RIRS, including preoperative stenting, use of ureteral access sheets, lithotripsy method, and renal drainage, remain open to discussion and linked to surgeon's preference. Moreover, there is a wide range of variation in efficacy and safety data, with major complications being episodic but often under-reported. RIRS has gained increased popularity among the urological community. This is certainly because of the continuous technological advancements, which have continuously improved the RIRS performance but also to the perception of ease and safety of this procedure when compared with the other available treatment modalities, particularly percutaneous nephrolitotomy. Indeed, the reported advances in RIRS technique have significantly improved the outcomes of this procedure but care should be taken not to underestimate its potential challenges.

Strike Rate: Analysis of Laser Fiber to Stone Distance During Different Modes of Laser Lithotripsy.

Introduction: Different techniques of laser lithotripsy (fragmentation, dusting, and popcorning) are commonly used during ureteroscopy. The efficiency of a single laser pulse is dependent on minimizing laser fiber-stone distance, yet it has not been reported how often the laser fiber is in contact with the stone during laser lithotripsy. In this study, we sought to measure laser fiber to stone distance using light reflectance for each technique of laser lithotripsy. Methods: Continuous light from a 660 nm (red) light-emitting diode (LED) was coupled into a 200 μm fiber using a fiber X-coupler. The LED fiber was positioned immediately next to a 242 μm holmium fiber, and both were passed through the working channel of an ureteroscope. One fiber was used to deliver laser energy to the stone, and the other fiber was used to measure distance based on light reflected from the stone back into the fiber. For fragmentation and dusting experiments, a 5 mm BegoStone was placed into a 20 mm three-dimensional printed caliceal model. For popcorn experiments, 10 BegoStones (3 × 3 × 1.5 mm) were placed in an 11 mm caliceal model and the laser fiber positioned 2 mm away from the stone surface. Data were analyzed using a MATLAB software to report fiber to stone distance at each laser pulse. Results: With fragmentation, 52% of laser pulses were delivered when the fiber was within 0.5 mm of the stone compared to 23% and 4% for dusting and popcorning, respectively. Laser pulses delivered when fiber to stone distance was >1 mm (least effective) accounted for 34%, 48%, and >80% of total pulses during fragmentation, dusting, and popcorning, respectively. Conclusion: Current methods of laser lithotripsy that rely on fixed firing rates are inefficient, especially for the popcorn technique. These data highlight areas for improvement by appropriately gating pulse delivery to maximize lithotripsy effect for each pulse fired.

Outcomes of Pneumatic Lithotripsy Versus Holmium Laser-Assisted Lithotripsy With Sialendoscopy in Management of Submandibular Sialolithiasis.

This study aimed to comparatively analyze the indications, treatment outcomes, and reliability levels of the intraductal pneumatic lithotripsy (IPL) and holmium laser-assisted lithotripsy (HLL) methods that are used to sialendoscopically separate stones into smaller pieces in submandibular gland sialolithiasis (SMGS) patients. To the best of the author's knowledge, there is no study that compared these 2 methods in the literature in English. The retrospectively designed study included 51 patients with SMGS. The IPL was used to break up 32 stones in 28 patients, while HLL was used to break up 28 stones in 23 patients. The stones could be completely extracted in 95.6% of the patients in the HLL group, 92.8% of those in the IPL group and 94.1% of all patients. The complete and partial recovery rates of the patients were respectively 91.3% and 8.7% in the HLL group and 92.8% and 7.2% in the IPL group. There was no significant difference based on the lithotripsy method that was used in the patients' laterality of stones, location of stones, stone diameter, operation time, need of papillotomy and silicone stent, complete removal status of stones and the symptomatic assessments of the patients in the 6th postoperative month. This study showed that both HLL and IPL treatments are effective, minimally invasive, and promising methods in difficult/complex SMGS treatments which may provide success rates of higher than 90% when they are performed by an experienced surgeon and by selection of appropriate patients.

What is the optimum lithotripsy method for high density stones during mini-PNL? Laser, ballistic or combination of both.

Percutaneous nephrolithotomy (PNL) is the primary treatment option for renal stones > 20mm in diameter. Mini-PNL gained popularity with its minimally invasive nature. The aim of this study was to compare the efficiency of ballistic and laser lithotripsy with the combined use of both techniques. Data of 312 patients underwent mini-PNL for renal stones with Hounsfield Unit > 1000 was investigated retrospectively. We identified 104 patients underwent combined ballistic and laser lithotripsy. Propensity score technique was used to create the laser and ballistic lithotripsy groups. Groups were matched on stone size, stone density, and Guy's stone score. Primary end point of the study was to compare the stone free rate (SFR), complication rates, and duration of surgery. Mean age of the population was 49.4 ± 6.1, stone size was 24.6 ± 6.3mm, and stone density was 1215 ± 89 HU. The groups were similar for age, stone size, stone density, and Guy's stone score. The SFR and the complication rates of the 3 groups were similar (p = 0.67). The duration of the surgery was shorter in the combined group (46.1 ± 6.3min) compared to the laser lithotripsy (54.5 ± 6.6min) and ballistic lithotripsy (57.2 ± 6.9min) groups. Both laser and ballistic lithotripsy are effective methods for stone fragmentation during mini-PNL. Combined use of both methods has the potential to improve the fragmentation rates and diminish the operative times in case of high density stones.

UP017 - What is the best lithotripsy method for high density stones during mini-PNL? Laser, ballistic or combination of both

UP017 - What is the best lithotripsy method for high density stones during mini-PNL? Laser, ballistic or combination of both

Thermal effect of holmium laser lithotripsy under ureteroscopy.

Thermal effect of holmium laser lithotripsy under ureteroscopy.

Giant urethral calculus in anterior urethral diverticulum: a case report

BackgroundIn this case report, giant calculus in the urethral diverticulum was found through ureteroscopy investigation, the pneumatic lithotripsy combined with ultrasound lithotripsy (PLCUL) was successfully performed to break down this rare and giant urethral calculus in the diverticulum without open surgery.Case presentationA 82-year-old male presented to the urology department, complaining of frequent urination and dysuria. One giant, dark brown stone (6.5 × 6 × 5.5 cm) was revealed in the diverticulum of the anterior urethra using combination of local ultrasound, pelvic Computer Tomography (CT) and Magnetic Resonance Imaging (MRI). The stone was then successfully broken down via the PLCUL, and the emptied anterior urethral diverticulum was left untreated. In the 18 months’ follow-up, no new calculus was found in urethral tract, anterior diverticula became gradually smaller, eventually disappeared.ConclusionIn the treatment of giant calculus in the urethral diverticulum, this case report provides an effective method of lithotripsy in the clinical trials.

Is mini-percutaneous nephrolithotomy the way to go for renal stones? Yes!

Is mini-percutaneous nephrolithotomy the way to go for renal stones? Yes!

Rationale for Choosing the Method of Lithotripsy in Patients with Ureterolithiasis with Concomitant Diabetes Mellitus

The work is devoted to improving the efficiency of treatment of patients with ureterolithiasis, burdened with diabetes mellitus, by studying the general homeostasis and functional ability of the kidneys with the identification of risk factors for the occurrence of complications after minimally invasive methods of ureterolithotripsy with predicting the choice of the best of them.The paper presents a theoretical generalization and a new solution to an actual scientific problem of improving the effectiveness of treating patients with ureterolithiasis on the background of diabetes mellitus by introducing an algorithm for determining the functional and restorative state of the kidney, studying the state of oxidative stress, ways to prevent the destruction of renal tissue performing minimally invasive lithotripsy methods.

22 - Role of obesity on the effectiveness of the Extracorporeal Shock Wave Lithotripsy (ESWL) method

22 - Role of obesity on the effectiveness of the Extracorporeal Shock Wave Lithotripsy (ESWL) method

The algorithm for choosing the method of lithotripsy in patients with nephrolithiasis without ureteropelvic junction obstruction using micro- and ultra-mini-percutaneous nephrolithotomy

It is important to increase the effectiveness of treatment in patients with nephrolithiasis who do not have ureteropelvic junction obstruction by creating an algorithm for choosing the proper surgical method. In the present study, 111 patients were examined who used the proposed algorithm, including new endovideoscopic methods such as micro- and ultra-mini-percutaneous nephrolithotomy. In the comparison group (73 patients), standard methods and approaches to the choice of lithotripsy procedures were used, without including new mentioned me­thods. It has been found that during the planning of percutaneous nephrolithotomy, computed tomography should be performed in the prone position which allows choosing more precisely the access site and, therefore, prevent trauma to the colon during percutaneous access. Compliance with the developed algorithm, taking into account the peculiarities of the clinical form of nephrolithiasis and using new endovideoscopic techniques, makes possible to select the most effective and least traumatic method of nephrolithotripsy therefore reducing the number of additional procedures per patient and associated complications.

Predicting surgical outcome of pediatric percutaneous nephrolithotomy

Purpose: The aim was to evaluate the outcome of pediatric percutaneous nephrolithotomy (PCNL) guided by Guy’s stone score grading system. Patients and methods: This was a prospective study of children with renal calculi more than 2 cm. They were younger than 18 years and were a candidate for PCNL at our University Hospitals from January 2013 until July 2016. All of them had a low-dose noncontrast enhanced computed tomography. The procedure was performed under general anesthesia with the patients in the prone position guided by fluoroscopy. The stone-free rate and the presence and type of complications were estimated. The demographic and clinical data, stone characteristics, radiologic anatomy as well the PCNL approach and methods of lithotripsy used were evaluated. Comparison was performed through using univariate and multivariate analyses, and factors predicting the PCNL outcome were determined. Results: A total of 110 children with kidney stones were accepted for PCNL. Overall, 95 (86.3%) of 110 children were stone free after one-stage PCNL. Grade 1 Guy’s stone score was 97.5% (40/41) ( P <0.05). Mean hospital stay was 4.01 ± 2.0 days. Operative complications include bleeding in 12 (10.9%), extravasation in seven (6.4%), injury to the colon in one (0.9%), and renal pelvis perforation three (2.7%). In our study, larger Amplatz sheath, stone burden, and longer operative time are related to complications. Conclusion: Guy’s stone score correlated with both success and complications and can be used for decision making preoperatively in pediatric PCNL. Keywords: Guy’s stone score, minimally invasive, percutaneous nephrolithotomy, pediatric, urolithiasis

An in vitro evaluation of laser settings and location in the efficiency of the popcorn effect.

To examine different locations and laser settings' effects on the efficiency of the "popcorn" method of laser lithotripsy, which consists of placing the laser in a group of small stones and firing continuously to break them into smaller particles. Pre-fragmented BegoStones were created between 2 and 4mm to mimic typical popcorning conditions. A 0.5g collection of fragments was placed into 3D-printed models (a spherical calyx and ellipsoid pelvis model) and a 200-µm laser fiber was positioned above the stones. The laser was fired for 2min with irrigation, with 5 trials at each setting: 0.2J/50Hz, 0.5J/20Hz, 0.5J/40Hz, 1J/20Hz, 0.2J/80Hz, 0.5J/80Hz. After drying, fragmentation efficiency was determined by calculating the mass of stones reduced to sub-2mm particles. Statistical analysis was performed with ANOVA and Student's t test. The trials within the calyx model were significantly more efficient compared to the pelvis (0.19 vs 0.15g, p = 0.01). When comparing laser settings, there was a difference between groups by one-way ANOVA [F(5,54) = 8.503, p = 5.47 × 10-6]. Post hoc tests showed a power setting of 0.5J/80Hz was significantly more efficient than low-power settings 0.2J/50Hz and 0.5J/20Hz (p < 0.05). Additionally, 0.2J/50Hz was significantly less efficient than 0.5J/40Hz, 1J/20Hz, and 0.2J/80Hz. Popcorning is most efficient in smaller spaces; we recommend displacement of stones into a calyx before popcorning. No difference was seen between high-power settings, although 0.5J/40Hz and 0.5J/80Hz performed best, suggesting that moderate energy popcorning methods with at least 0.5J per pulse are most efficient.

Сроки рецидивирования после полного удаления конкрементов в разных отделах мочевой системы. Опыт пятилетнего наблюдения

The usage of minimally invasive technologies (MIT), such as: extracorporeal shock wave lithotripsy (ESWL), transurethral ureterolithotripsy (URS), retrograde intrarenal surgery (RIRS), percutaneous nephrolithotripsy (PNL), allows to remove the stones from the calyx and pelvis system with 71- 96% of patients, and those from the ureter in 96.2% cases. However, a high incidence of stone recurrences (35-75%) demands the necessity of repeated lithotripsies and the search of the most appropriate methods of lithotripsy for reduction this indicator. The main goal. To determine the number of patients with recurrence of stone formation during five years after different types of lithotripsy in different parts of the urinary system. The results of the process were analyzed with 491 patients, who had been devided into two groups: group I - 358 patients suffering from the concrements of the ureter; group II - 133 patients having stones in kidney. According to the age criterion, the sample data did not differ from each other (50 years for both groups (p=0.576). The initial number of lithotripsies with complete removal of stones was 80.7% in group I and 70.7% in gr. II, the repeated lithotripsy with usage of the same method was 5.9% and 12.8%, respectively. The usage of an additional method in repeated lithotripsy was necessary in 13.4% and 16.5% of cases respectively. There were differences between the sizes of stones in groups (p<0.0001), besides both groups showed the difference in recurrence time of stone formation (p=0,014). In gr. I weak negative correlation (-0.28) between age and time of recurrence was revealed. The age difference between men and women in both groups (p=0.00001 and p=0.0492, respectively) was found. There occurred differences in the size of stones in men and women groups (p=0.0000001 and p=0.0000001, respectively) and in the time of recurrence between men and women in I gr. (p=0.043). Most of stones were compose of CaOx, the second most important element was Uric Acid. All this testifies to peculiarities of the diet in the region of residence of the patients under control - the Republic of Bashkortostan, where people generally use meat and milk products. The usage of MIT opened the possibility of complete stone removal from the urinary system with the most sparing technique. The lithotripsy of stones with any composition having been conducted, additional stone crushing is carried out with 21-59% of patients within 5 years. The investigation of patients detected a great number of recurrences of stones in the kidney stones group. 1. After lithotripsy the recurrences during two years did not exceed 4,2% with patients in gr. I and 8,2% in gr. II patients. 2. Significant dependence of recurrent stone formation of gender composition was identified in gr. I and the time of recurrence was less in women. 3. The quantity of CaOx urolithiasis corresponds to global indicators. However, a large number of stones with Uric Acid in the composition indicates possible peculiarities of the patients diet. 4. The highest number of recurrences were in patients with CaOx (42.3%) and CaOx with CaF in the composition (23.1%), and in third place were patients with uric acid stones (19.2%).

Ultra-mini PСNL versus RIRS in treatment of patients with nephrolithiasis

A comparative analysis of the two methods of contact lithotripsy was held in 41 patients with nephrolithiasis. Ultra-mini percutaneous nephrolithotripsy (Ultra-mini PСNL) was performed in the І group (19 patients) using sheath with outer diameter of 11Fr. Retrograde intrarenal surgery (RIRS) in the ІІ (22 patients). We can regard ultra-mini PСNL as safe, mini-invasive, effective procedure in management of renal calculi up to 2 cm in diameter. RIRS is the procedure of choice in patients with a JJ-stent previously installed due to obstruction because predilation of the ureter facilitates advancement of the ureteral access sheath. There was no significant difference in stone free rate between the groups, but ultra-mini PСNL is associated with shorter hospital stay, lower cost, shorter fluoroscopy time, greater postoperative hemoglobin drop. RIRS is accompanied by greater incidence of JJ-stent placement, less need for pain medication in postoperative period.

Модифікації уратно-оксалатного обміну у пацієнтів із цукровим діабетом після малоінвазивного лікування з приводу уретеролітіазу

The objective: of the study was to study the status of urate-oxalate exchange in peple with ureterolithiasis and concomitant diabetes mellitus undergoing various methods of non-invasive surgical treatment of urinary stones. Patients and methods. The study involved 164 patients and 12 healthy volunteers, of whom men accounted for 93 (56.7%), women – 71 (43.3%) persons. The age range of patients is 19–53 years, on average – 34.6±5.5 years. The average age of women is 30.1±2.9 years, and men are 37.6±3.1 years. Patients were divided into IV clinical groups: I – patients with ureterolithiasis and diabetes, which were performed by TUKL (n=34); II – patients with ureterolithiasis and diabetes, which were conducted by the EWHL (n=32); III – patients with ureterolithiasis without diabetes, which was performed by TUKL (n=41); IV – patients with ureterolithiasis without diabetes, which was performed by ESWL (n=57). The control group consisted of healthy volunteers with no signs of pathology (n=12). The studies were performed before and after disintegration of stones by the method of transurethral contact lithotripsy (TUKL) and ESWL. The diagnosis of SCH was verified using clinical, anamnestic, laboratory and instrumental research methods in accordance with the MOH protocols, before and after the disintegration of stones by the method of transurethral contact lithotripsy (TUCL) and ESWL. Results.The analysis of the above-mentioned data found that in the presence of ureterolithiasis in people with diabetes, there were significant changes in daily pH indices in the form of monotony of the indicator curve, with a rather high shift towards acidification. Constant urine pH is an important marker for excretory renal function in the presence of urinary tract, diabetes, and diabetes. Strongly sour urine reflects the peculiarities of the flow of uratogenic urolithiasis in the conditions of the DN, indicating the absence of isolated violation by the GKO and outlines this state as a two-way. Conclusion. Hypocytarturia was established in all cases of CKD, but in urine subjects with diabetes, excrement rates of citrate were as low as possible. In patients with diabetes mellitus and concomitant ureterolithiasis, there are significant disturbances in the metabolism of uric acid and oxalate, with the possibility of correction in case of rapid and complete recovery of urodynamics by noninvasive methods (TUKL). Key words: ureterolithiasis, diabetes mellitus, urates, oxalates, minimally invasive methods of lithotripsy.

Показники глікемічних профілей крові в осіб із цукровим діабетом, що зазнали малоінвазивного лікування з приводу уретеролітіазу

The objective: to study the state of the glycemic profile in patients with ureterolithiasis and concomitant diabetes mellitus (DM) who underwent various methods of minimally invasive surgical treatment. Patients and methods. The study involved 204 people, 130 (63.7%) men and 74 (36.3%) women, the average age – 34.6±5.5 years. Subjects were divided into VI clinical groups: I – persons with diabetes and ureterolithiasis, who underwent TUСL and CS therapy per os (n=57); II – persons with DM and ureterolithiasis, who underwent TUСL without HS therapy (n=44); III – persons with DM and ureterolithiasis who were treated with ECU without HS therapy (n=32); IV – persons with ureterolithiasis without diabetes who underwent TUСL without HS therapy (n=41); V (control 1) – of the person with diabetes, who had an independent passage of stones from the ureter (n=18); VI (control 2) – healthy volunteers, with no signs of pathology (n=12). The diagnosis of ureterolithiasis was verified using clinico-anamnestic, laboratory and instrumental methods of investigation, according to the MHP protocols, before and after the disintegration of the stones by the method of transurethral contact lithotripsy (TUСL) and ESWL. Results. Elevated levels of HbA1c indicated chronic hyperglycemia for a long time, with the presence of violations of carbohydrate homeostasis and the need for its correction before and during surgery for ureterolithiasis. At this minimally invasive treatment of ureterolithiasis, the presence of an operational injury factor, with manifestations of permanent obstruction in the upper urinary tract (ESWL operation) did not contribute to a decrease in glucose levels in plasma and urine, unlike states with rapid elimination of acute calculous process (TUCL operation). Conclusion. Assistance to patients with diabetes mellitus, which is planned surgical treatment, allows to improve the condition of patients in the postoperative period and reduce the risk of postoperative сomplications. Key words: ureterolithiasis, diabetes mellitus, glycosylated hemoglobin, glucosuria, minimally invasive methods of lithotripsy.