Comparison of Ho:Yag laser and pneumatic lithotripsy combined with transurethral prostatectomy in high burden bladder stones with benign prostatic hyperplasia.
OBJECTIVE
To compare the efficacy and reliability of Ho:YAG laser lithotripsy (HLL) and pneumatic lithotripsy (PL) in the treatment of bladder stones in patients with benign prostatic hyperplasia and stones ≥ 20 mm who were transurethrally treated in the same surgical session.


METHODS
We studied the data of patients with benign prostatic hyperplasia and ≥20 mm bladder stones who were treated with transurethral resection of the prostate and cystolithotripsy in the same session, obtained between January 2010 and February 2014 from three urology clinics. All patients underwent bipolar plasmakinetic (PK) transurethral resection of the prostate. For treatment of the bladder stone, either HLL or PL was applied. A total of 62 patients were divided into two groups: PK-PL (Group 1, n = 29) and PK-HLL (Group 2, n = 33). The data of both groups were analyzed for stone dimensions, stone fragmentation time, total operating time, hospitalization duration, prostate dimensions, success rates, and complications.


RESULTS
Group 1 included 29 patients with a mean age of 70 ± 7.6 (range, 57-85) years, whereas Group 2 included 33 patients with a mean age of 67.5 ± 10.5 (range, 45-84) years. In Group 1, five patients had mucosa injury, one patient had residual stone, and one patient had bladder perforation. In Group 2, three patients had mucosa injury, three patients had postoperative fever, and one patient had residual stone. Total operation time and stone fragmentation time were significantly lower in Group 2 (p < 0.05). The remaining analyzed data were similar (p > 0.05).


CONCLUSIONS
PK-HLL using a single shaft without the need for repeated access has the advantages of shorter fragmentation and operation time.
Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey. Electronic address: hakanercil@yahoo.com.
Hakan
H
Ercil
Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey.
Adem
A
Altunkol
Department of Urology, Ministry of Health, Dr. Askım Tufekci Government Hospital, Adana, Turkey.
Ergun
E
Alma
Department of Urology, Baskent University Adana Training and Research Center, Adana, Turkey.
Mehmet Resit
MR
Goren
Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey.
Nevzat Can
NC
Sener
Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey.
Faruk
F
Kuyucu
Department of Urology, Ministry of Health, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Ahmet Nihat
AN
Karakoyunlu
Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey.
Ediz
E
Vuruskan
Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey.
Ferhat
F
Ortoglu
Department of Urology, Ministry of Health, Haseki Training and Research Hospital, Istanbul, Turkey.
Zafer Gokhan
ZG
Gurbuz
D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008096:Lithotripsy / Q000379:methods*; D017602:Lithotripsy, Laser; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D001744:Urinary Bladder Calculi / Q000150:complications / Q000628:therapy*
benign prostatic hyperplasia; bladder stones; laser lithotripsy; pneumatic lithotripsy