Laser or pneumatic lithotripsy in pediatric ureteral stones: Which one is more effective?

Abstract

Objective: The aim of this retrospective study was to compare the effectiveness of pneumatic and laser lithotripsy in the treatment of pediatric ureteral stones. Methods: Among 60 cases of ureteral stones with a complete clinical follow-up between 2008 and 2012, clinical variables of patients, localization and stone load before ureteroscopy, energy source of lithotripsy, complication rate and follow-up period were evaluated retrospectively. Indication for ureteroscopy was accepted as the failure of extracorporeal Shockwave lithotripsy, clinically significant obstructive uropathy and acute symptomatic patients. Results: Thirty-six (60%) and 24 (40%) patients underwent the pneumatic and the laser lithotripsy, respectively. There was no statistically significant difference between the two groups preoperatively in terms of gender (p=0.133), age (p=0.211), stone size (p=0.101), stone load (p=0.850) and location (p=0.301). After pneumatic and laser lithotripsy, 6 (16%) and 4 (16.7%) patients had clinically significant residual stones, respectively (p=0.83). Residual stones were seen in the upper ureteral stones that migrated up during lithotripsy. Conclusion: Both of the lithotripsy methods were found to be equally effective in pediatric populations. On the other hand, lower complication rates obtained in laser lithotripsy incline us to use the laser lithotripsy because of its safety as an energy source.