Role of lasertripsy in the management of ureteral calculi: experience with alexandrite laser system in 232 patients.
In 232 patients with ureteral stones, lasertripsy was used as primary treatment or as second-line therapy after extracorporeal shockwave lithotripsy (SWL). In all patients, a semirigid 6.5F ureteroscope or a flexible 6F ureteroscope was used. Lithotripsy was performed employing an alexandrite laser with an energy of 50 to 65 mJ. The immediate success rate was 67.5% for stones in the upper ureter, 86.1% for those in the midureter, and 94.5% for those in the distal ureter. In 16.5% of the treatments, it was necessary to insert a double-J stent. A perforation of the ureter happened in two patients (0.9%), but no laser-related complications were seen. Stone fragmentation was not dependent on stone composition or size. Using small semirigid or flexible ureteroscopes, lasertripsy of ureteral stones is a minimally invasive treatment with an insignificant complication rate. In case of midureteral stones, our results revealed a higher immediate stone-free rate than is reported in the literature after treatment by SWL, and we can therefore recommend lasertripsy as primary treatment. For upper ureteral stones, lasertripsy can be recommended as a helpful auxillary procedure. Furthermore, in cases of distal ureteral stones, lasertripsy challenges SWL as the primary treatment.
Jung
P
P
Urologic Clinic, Medical Faculty, RWTH Aachen, Germany.
Wolff
J M
JM
Mattelaer
P
P
Jakse
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000537:Aluminum Oxide; D001608:Beryllium; D005260:Female; D006801:Humans; D017602:Lithotripsy, Laser / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*
D000537:Aluminum Oxide; D001608:Beryllium