KUMJ | VOL. 18 | NO. 1 | ISSUE 69 | JAN.-MARCH, 2020
Outcome of Uretero Renoscopic Lithotripsy (URSL) with Holmium LASER Vs Pneumatic Lithotripter for Lower Ureteric Stones, Experience from University Hospital of Nepal
Joshi HN, Singh AK, Koirala N, Karmacharya RM
Abstract: Background
There are various methods of endoluminal ureteral stone fragmentation. Among
various modalities Laser lithotripsy and Pneumatic lithotripsy are commonly used
and have shown comparable outcomes.
Objective
To compare the efficacy and outcome of laser and pneumatic lithotripsy in a patient
with lower ureteric calculi. The comparison will be done in stone free rate, migration
of stone and complication of the procedure.
Method
This is a prospective comparative study in a cohort of patients at University Hospital
with Lower Ureteric stone. Ninety patients were randomized in to two groups (Laser
Lithotripsy Vs Pneumatic Lithotripsy) during the study period. The purpose of this
study was to measure the immediate stone free rate, intra-operative complications,
mean operative time, post-operative complication and if any stone retention after six
weeks follow up.
Result
Both the groups were similar in Age and Gender. Immediate stone free rate was
slightly higher in Laser lithotripsy group (97.77%) in comparison to Pneumatic
lithotripter group (84.44%) with p=0.507 which is not statistically significant. There
was statistical difference in terms of stone migration rate, mean operation time
in favor of Laser Lithotripsy group (p<0.01, in both parameters). There were no
immediate complications in both the group however there were three cases of short
segment ureteric strictures (6.66%) in case of Pneumatic lithotripsy on six weeks
follow up which was managed conservatively.
Conclusion
Both LASER lithotripter and Pneumatic lithotripter are equally efficacious modality
of endoluminal URSL in lower ureteric stone with similar Stone Free Rate. Laser
lithotripsy showed lower frequency of stone migration and had shorter procedure
time.
Keyword : Laser lithotripsy, Lower ureteric calculus, Pneumatic lithotripsy
