A comparison of holmium:YAG laser with Lithoclast lithotripsy in ureteral calculi fragmentation.
OBJECTIVE
Among various intracorporeal lithotriptors, Lithoclast (EMS, Switzerland) has become the widely used tool for the treatment of urinary stones. Recently, the holmium:YAG laser has been used with a wide range of potential urological applications, including intracorporeal lithotripsy of urinary calculi. The purpose of the present study is to compare Lithoclast with holmium:YAG laser lithotripsy in ureteral calculi fragmentation.


METHODS
Out of 51 patients with ureteral calculi, 26 underwent Lithoclast lithotripsy and 25 holmium:YAG lithotripsy using a 8/9.8F rigid ureteroscope. There were no changes to the ureteroscopes, video monitors, baskets or irrigation devices during the study period.


RESULTS
There were no differences in patient age, sex, stone size and location of stones between these groups. The immediate stone-free rates were 96.0% in the holmium:YAG group and 73.1% in the Lithoclast group (P < 0.05). The 3-month stone-free rates were 96.0% and 84.6%, respectively (P = 0.350). The mean operation time and mean period of postoperative hospitalization in the holmium:YAG group (49.8 min and 1.0 days, respectively) were shorter than those of the Lithoclast counterpart (76.9 min and 2.5 days, respectively). Post-treatment complications, such as ureteral perforation, were encountered in only two patients who underwent Lithoclast.


CONCLUSIONS
Holmium:YAG lithotripsy was associated with shorter operation time and postoperative hospitalization period. These data also suggest that holmium:YAG lithotripsy was safe and more effective than Lithoclast lithotripsy in the aspect of immediate stone free rate. We believe that holmium:YAG laser is an excellent treatment modality for managing ureteral calculi.
Jeon
Seong Soo
SS
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.
Hyun
Ji-Hwan
JH
Lee
Kyu-Sung
KS
D000328:Adult; D000368:Aged; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology / Q000628:therapy; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects / Q000592:standards*; D017602:Lithotripsy, Laser / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000293:injuries; D014514:Ureteral Calculi / Q000628:therapy*; D018666:Ureteroscopy; D014950:Wounds, Penetrating / Q000209:etiology