Comparison of pneumatic lithotripter and holmium yag laser in transureteral lithotripsy (TUL)

Abstract

(Objective) We retrospectively compared the clinical outcomes of Lithoclast® assisted lithotripsy (L group) with those of Holmium YAG laser assisted lithotripsy (H group). (Patients and methods) We analyzed records for operation time, duration of ureteral stenting. complication and stone-free rates in the L group (388 patients) and the H group (368 patients) for the primary procedure. (Results) The stone locations (L group/H group) were U1 in 141/181, U2 in 69/57, and U3 in 178/130. Respective median stone sizes (L group/H group) were: Ul,: 10.0/10.0 mm; U2,: 7.0/10.0 mm;, and U3,: 6.0/7.0 mm. Secondary procedures were performed in 79 L group patients and 35 H group patients. The median operation times (L group/H group) were 29.5/25.0 minutes. The median durations of ureteral stenting (L group/H group) were 4.0/4.0 days. The stonefree rates (L group/H group) according to the locations of the stones were 69.3/82.0% in Ul, 85.5/87.0% in U2, and 92.0/98.4% in U3. Complications (L group/H group) were ureter perforation in 8/5 cases, pyelonephritis in 7/2 cases, ureteral stricture in 2/6 cases, and stone push up in 27/13 cases. (Conclusion) The operation time for holmium YAG laser assisted lithotripsy was significantly shorter than that of the Litoclast® assisted procedure, and the stone-free rate with holmium YAG laser assisted lithotripsy was better than that with Lithoclast® assisted lithotripsy for Ul and U3 stones.© 2013 The Japanese Urological Association.