Comparison of Ho:Yag laser and pneumatic lithotripsy combined with transurethral prostatectomy in high burden bladder stones with benign prostatic hyperplasia (original) (raw)
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Evaluation of pneumatic versus holmium:YAG laser lithotripsy for impacted ureteral stones
International Urology and Nephrology, 2011
Purpose We prospectively analyzed and compared the effectiveness and complications of pneumatic lithotripter with a holmium:yttrium-aluminum-garnet (Ho:YAG) laser for the ureterorenoscopic management of impacted ureteral stones. Materials and methods From January 2006 to January 2008, we performed retrograde endoscopic treatment in 288 patients with ureteral stones in our clinic. The patients with impacted stones were randomized into two groups according to the lithotripter used to fragment the stone: pneumatic (n = 40) and laser (n = 40). The preoperative, operative, and post-operative follow-up findings were analyzed and compared. Results The average stone size was similar in both groups (118.8 ± 58.3 mm 2 vs. 110.7 ± 54.4 mm 2). The calculi were located in the distal ureter in most of the patients in both groups (65% in pneumatic group and 52.5% in laser group). The operation time was significantly diminished in the laser group (P = 0.001). The stone-free rates after a single ureteroscopic procedure were 80 and 97.5% in the pneumatic and laser groups, respectively (P = 0.03). Auxiliary treatments were needed in seven patients in the pneumatic group, while only one patient in the laser group (P = 0.05) needed this treatment. After the additional procedures, a 100% success rate was achieved in both groups. The rate of double J stent insertion was significantly higher in the pneumatic group (P = 0.01). In the pneumatic group, four cases of stone up-migration and one case of post-operative stricture were seen, whereas only one case of stone up-migration was noted in the laser group. Conclusion Our comparative study has shown that the use of Ho:YAG as an intracorporeal lithotripter during ureteroscopic management of impacted ureteral stones is highly efficient with high success rates, regardless of the stone location.
Bangladesh Journal of Urology, 2020
Objective: To compare the outcomes of ureteroscopic lithotripsy with pneumatic lithotripter versus Holium:Yttrium-Aluminum-Garnet (Ho:YAG) laser in the management of upper ureteric stones. Materials and methods: Patients who underwent ureteroscopic lithotripsy with pneumatic lithotripter or Ho:YAG laser for upper ureteric stones were reviewed. Patients with urinary tract infection, ,loss of follow-up, concurrent middle or lower third ureteral stones or acute renall failure were excluded. Patient age, stone size and burden (based on KUB or computerized tomography), stone upward migration, double J stent insertion rate, stone free rate and secondary intervention rate for residual stones were compared in both groups. Results: There were 70 patients with upper ureteric stones (35 in pneumatic group and 35 in laser group) meeting the study criteria. Patients’ age, gender, stone size and burden were similar in both groups. The Ho:YAG laser lithotripsy group had better stone free rate, les...
OUTCOMES OF PNEUMATIC LITHOTRIPSY VERSUS HOLMIUM LASER IN DISTAL URETERIC STONES QR code
Objective: To compare the outcomes of pneumatic lithotripsy versus holmium laser in distal ureteric stones Study Design: Cross sectional study Setting & Duration of Study: The study was conducted at department of Urology in Sindh Institute of Urology and Transplantation (SIUT) Karachi. Six months. Since 1 st July 2020 till 31 st December 2020. Method: 208 patients who underwent Pneumatic Lithotripsy and Holmium Laser in Distal ureteric stones were selected for the study, who were randomized into 2 groups of 104, in each group the success rate in the pneumatic group and in laser group is calculated. Outcomes were assessed in terms of intra-operative time period, stone migration, need for stent placement, hospital stay and stone clearance. Results: There were total 208 cases of mean age of 37.15±9.14 years. When they were evaluated for stone size mean size of stone was 8.9±2.24mm of which the mean stone size of pneumatic lithotripsy was 8.50±2.21 and in the Ho: YAG laser group was 9.13±2.22. On comparison, it was noted that pneumatic lithotripsy was effective in 65 (62.5%) and Ho: YAG laser in 89 (85.57%) with a statistically significant difference (p< 0.06). On stratification, it was noted that there is no significant impact of age on the efficacy of the treatment. Ho: YAG laser was effective in 71 (79.77%) in age group <30 and showed the results of Ho: YAG laser 18 (20.22%) in >40 year of age. But there was significant difference for the size of stone in the treatment groups with a p-value of <0.05 as significant. Conclusion: Outcomes are better in patients of ureteric stones having laser lithotripsy as compared to the patients having pneumatic lithotripsy.
Evaluation of Pneumatic Vs Holmium: YAG Laser Lithotripsy in the Treatment of Ureteric Stone
Janaki Medical College Journal of Medical Science
ABSTRACT Background and objectives: Among many lithotripters for fragmentation of ureteric stones, pneumatic and Holmium: YAG laser lithotripsy has reported favorable outcomes. The aim of this study is to compare the efficacy of pneumatic lithotripsy with laser lithotripsy in ureteral stone. Materials and methods: In this prospective study, 60 patients with diagnosis of ureteral calculus underwent ureteroscopic lithotripsy in Urology Unit, Department Surgery, National Medical College and Teaching Hospital over period of 2020 to 2021. They were divided randomly into two groups, each group with 30 patients. Group PL was treated with Pneumatic lithotripsy and Group LL was treated with Holmium: YAG laser lithotripsy. History and detailed clinical examination was performed as per the working proforma which included. Result of both the procedures was assessed. Chi square test were used for correlation analysis. Data analysis was done using SPSS (Statistical Package for social science...
Holmium: YAG Laser in the Management of Impacted Ureteral Stones HYLe Study
Pakistan Journal of Medical and Health Sciences, 2022
Background: Holmium: yttrium-aluminium-garnet (YAG) laser is considered cost-effective and efficient choice in ureteroscopic lithotripsy on all types of stones. We aim to evaluate the efficacy of Holmium: YAG laser in impacted ureteral stones. Methods: We conducted a prospective case series at the Sindh Institute of Urology and Transplantation (SIUT) Pakistan from 1st October 2016 till 30th September 2017. All adult patients between 18 to 60 years of age with single <20mm ureteral stone impacted for more than one month. The primary outcomes include stone-free and recurrence of ureteric stone during two-year follow-up. Analyses performed using SPSS version 21.0. Results: A total of 117 patients recruited, of which most were males (61,52.14%). The average duration of disease was 7.82±1.79 months, with a stone size of 12.49±3.8 mm. Most of the stones were located in the middle of the ureter (56,47.86%). Holmium: YAG laser for treatment was effective in 99 (84.62%) cases, and efficac...
Bangladesh Journal of Urology, 2020
Background:Among various intracorporeal lithotripters, Pneumatic lithotriptorhas become the widely used tool for the treatment of ureteric stones. Recently the Holmium:YAG laser has been used with a wide range of potential urological applications, including intracorporeal lithotripsy of ureteric stones. Objective: To compare the treatment of upper ureteric stone between laser and pneumatic lithotripsy. Materials and methods: One hundred patients with upper ureteric stone who underwent ureteroscopic lithotripsy in the Department of Urology, CMH, Dhakafrom October 2012 to September 2015 were enrolled in this study. Patients were divided into two groups. Group A (LL) were treated with holmium: YAG laser and Group B (PL) were treated with pneumatic lithotripsy. Two procedures were compared in term of stone fragmentation, stone clearance rate, duration of lithotripsy, complications and duration of post operativehospital stay. Patients were monitored as outpatients after one month and aft...
Urology, 2005
Objectives. To compare the safety and cost-effectiveness of ureterorenoscopic holmium:yttrium-aluminum-garnet (YAG) laser lithotripsy (URSL) with extracorporeal shock wave lithotripsy (ESWL) for proximal ureteral stones. Methods. This investigation assessed 220 patients with upper ureteral stones. Those in the ESWL group were treated on an outpatient basis using the Medispec Econolith 2000 (Medispec, Germantown, Md) under intravenous sedation. URSL was performed with a 6/7.5F semirigid tapered ureterorenoscope and holmium: YAG laser under spinal anesthesia on an inpatient basis. A successful outcome was defined as the patient being stone free on radiography 1 month after treatment. The stone size, success rate, postoperative complications, and cost were evaluated in each group. Results. A total of 220 patients were enrolled in this study. Hematuria and flank pain were the most common complaints in each group. The mean stone burden Ϯ SD was 58.7 Ϯ 3.1 mm 2 in the ESWL group and 108.4 Ϯ 10.0 mm 2 in the URSL group (P ϭ 0.000). The accessibility of the semirigid ureterorenoscope for upper ureteral stones was 98.1% (101 of 103), and the stone-free rate achieved after one treatment was 83.2% (84 of 101). The initial stone-free rate of in situ ESWL was 63.9% (76 of 119). Significantly, the initial stone-free rate of the URSL group was superior to that of the ESWL group (P ϭ 0.001). The average cost in the URSL group appeared to be lower than that in the ESWL group (P ϭ 0.000). Conclusions. The results of this study have demonstrated that URSL achieved excellent results for upper ureter calculi. In terms of cost and effectiveness, this procedure should be the first-line therapy for proximal ureter stones. UROLOGY 65: 1075-1079, 2005.
African Journal of Urology, 2020
Background The aim of this study is to evaluate the outcome of ureteroscopic lithotripsy of combined pneumatic and laser versus laser lithotripsy alone for the treatment of impacted pelvic ureteral stones. Ninety patients with impacted stones 10 mm or more were selected and divided into two equal groups. The combined group included patients who treated by pneumatic lithotripsy (PL) and laser lithotripsy (LL), while those in the laser group were treated by LL alone via retrograde semirigid ureteroscopy. Exclusion criteria included urinary tract infection, radiolucent stones, ipsilateral concurrent stone, previous ureteral surgery, urinary tract anomalies, musculoskeletal deformities, renal failure and pregnancy. Any stone retropulsion or any residual stone detected 1 month postoperative was considered failure. Results The stone-free rate was 88.8% and 91.1% for laser and combined groups, respectively, which was statistically insignificant (p ≥ 0.05). Operative complications were 11.1...