title: Safety and Efficacy of Pneumatic Lithotripters Versus Holmium Laser on Multiple Ureteral Calculi.
abstract: BACKGROUND
  Different energy sources can be used for ureteroscopic stone fragmentation, such as pneumatic, ultrasonic, laser or electrohydraulic. The aim of this study was to compare the efficacy and safety of pneumatic lithotripters versus Ho: YAG laser in the treatment of multiple stones in the distal ureter.
  
  
  METHODS
  A retrospective evaluation was done using the data of patients to whom ureteroscopic lithotripsy (URL) was applied for ureter stones in our clinic. From these patients, those with multiple unilateral distal ureter stones were identified, then these patients were separated into 2 groups according to the type of lithotriptor used in stone fragmentation as laser lithotripsy (Group 1) and pneumatic lithotripsy (Group 2).
  
  
  RESULTS
  Statistically, the two groups were similar in respect of the number of stones, stone burden and the number of double J stents applied intra-operatively. The mean operating time was similar in the 2 groups as 53.47 (±17.3) minutes in Group 1 and 50.59 (±15.3) minutes in Group 2. On postoperative day 1 after the URL, the stone free rate (SFR) of Group 1 (78.7%) was found to be significantly high compared to the SFR of Group 2 (63.6%), while at postoperative month 1, the SFR of both groups was found to be similar. Binary logistic regression was applied to determine the effect of related independent variables on the 1st month SFR. In this model, age and stone burden were affecting variables.
  
  
  CONCLUSIONS
  Compared to the pneumatic lithotripter, the Ho: YAG laser seems to have advantages of a higher SFR in the early postoperative period, eventhough there are statistically similar success rates and complication rates.
authors.affiliation: Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ercil
authors.affiliation: Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Ergun
authors.initials: E
authors.lastname: Alma
authors.affiliation: Department of Urology, Ministry of Health, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Okan
authors.initials: O
authors.lastname: Bas
authors.affiliation: Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Umut
authors.initials: U
authors.lastname: Unal
authors.affiliation: Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Nevzat Can
authors.initials: NC
authors.lastname: Sener
authors.affiliation: Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Ediz
authors.initials: E
authors.lastname: Vuruskan
authors.affiliation: Department of Urology, Hitit University Corum Education and Training Hospital, Corum, Turkey.
authors.forename: Aykut Buğra
authors.initials: AB
authors.lastname: Senturk
authors.affiliation: Department of Urology, Ministry of Health, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Zafer Gokhan
authors.initials: ZG
authors.lastname: Gurbuz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014513:Ureter; D014514:Ureteral Calculi / Q000601:surgery / Q000628:therapy*; D053039:Ureterolithiasis / Q000601:surgery / Q000628:therapy*