Pneumatic Lithotriptor vs Holmium : YAG Laser in management of Ureteral Calculus (original) (raw)
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Background: Among many lithotripters available for fragmentation of ureteric stones, pneumatic and Holmium: YAG laser lithotripsy have reported favorable outcomes. Aim of this study is to compare the intracorporeal Holmium: YAG laser with pneumatic lithotripsy in ureteral calculi fragmentation in terms of fragmentation time, stone migration, intra-operative and post-operative complications, stone free rate and need for auxiliary procedures. Material & Methods: Fifty patients selected with diagnosis of calculus in ureter suitable for endoscopic treatment. They were subsequently randomized in to two groups by sealed envelope method. Group 1 was treated with Holmium: YAG laser lithotripsy and group 2 with pneumatic lithotripsy. All patients with ureteral calculi of size 6-20 mm were included while stone size >20mm, patients with sign of sepsis, pregnancy, renal insufficiency or urinary tract abnormalities were excluded from the study. Results: Maximum number of cases (64%) were from 21-40 years age group in both the groups, while least number of cases (8% of all) were from age group <20 years in pneumatic (4%) and Holmium group (12%) respectively. At six weeks, only 22 patients were stone free in pneumatic group (88%) while all patients in holmium group (100%) were free of stones. However, difference was not statistically significant (p=0.074). Conclusion: Both Holmium: YAG laser lithotripsy and Pneumatic lithotripsy are very safe methods of ureteroscopic stone fragmentation in experienced hands. However, Holmium: YAG laser is more successful in treatment of upper ureteric stones.
Treatment of ureteric calculi--use of Holmium: YAG laser lithotripsy versus pneumatic lithoclast
JPMA. The Journal of the Pakistan Medical Association, 2007
To compare the efficacy of Holmium: YAG laser and pneumatic lithoclast in treating ureteric calculi. The study included total of 100 patients divided into two equal groups of laser lithotripsy (LL) and pneumatic lithoclast (PL). Study was conducted between September 2006 and February 2007. Inclusion criteria were patients with a ureteric stone of size 1-2 cm and negative urine culture. An x-ray KUB was mandatory. IVU and CT pyelogram were also done when required. Procedures were done under general anaesthesia after a single dose of pre-operative antibiotic. A 7.5 Fr semi rigid ureteroscope was used for ureteroscopy in all cases. Holmium: YAG laser with 365 microm wide probe was employed in laser group and frequency was set between 5 and 10 Hz at a power of 10 to 15 W. Swiss lithoclast with single or multiple fire technique was used accordingly in PL group. Postoperatively patients underwent radiography and helical CT as required at 4th week of follow up to asses stone clearance. The...
Bangladesh Journal of Urology
Objective: To compare the efficacy of Holmium laser and pneumatic lithotripsy for the treatment of lower ureteric calculi. Methods: The study included total of 218 patients divided into two groups of laser lithotripsy (LL) and pneumatic lithotripsy (PL). Study was conducted between October 2014 and September 2018. Inclusion criteria were patients with a lower ureteric single stone of size 0.8 to 1 cm and negative urine culture. An x-ray KUB and USG of KUB was mandatory. IVU also done when required. Procedures were done under spinal anesthesia. A 9.5 Fr. semi rigid ureteroscope was used for ureteroscopy in all cases. Holmium laser with 550 ìm fiber was employed in laser group and frequency was set between 20-30 Hz at energy of 0.5 to 1 Joule. Storz lithotripter was used in PL group. Postoperatively patients underwent radiography at 4th week of follow up to assess stone clearance. Results: The mean patient age in LL and PL group was 38.8±9.1(15-58) and 41.2±10.3(16-62) years, male to ...
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...
International braz j urol : official journal of the Brazilian Society of Urology, 2016
To analyse outcomes of holmium laser and pneumatic lithotripsy in treatment of lower ureteric calculus in pediatric patients. Prospective study conducted between August 2013 and July 2015. Inclusion criteria were lower ureteric calculus with stone size ≤1.5cms. Exclusion criteria were other than lower ureteric calculus, stone size ≥1.5cms, congenital renal anomalies, previous ureteral stone surgery. Patients were divided into two groups. Group A underwent pneumatic and group B underwent laser lithotripsy procedure. Patient's baseline demographic and peri-operative data were recorded and analysed. Post operatively X-ray/ultrasound KUB (Kidney, ureter and bladder) was performed to assess stone free status. A total of 76 patients who met the inclusion criteria to ureteroscopic intracorporeal lithotripsy were included. Group A and B included 38 patients in each. Mean age was 12.5±2.49 in Group A and 11.97±2.74 years in Group B respectively (p=0.38). Overall success rate was 94.73% i...
Urologia internationalis, 2016
Holmium YAG laser lithotripsy (LL) and pneumatic lithotripsy (PL) are the most commonly used procedures in the treatment of ureteral calculi. In a previous meta-analysis examining the treatment effect of the 2 modalities, the authors highlighted the need for large sample size and high quality trials to provide more uncovered outcome. Recently, several randomized controlled trials (RCTs) evaluating the same issue with larger patient number and more complicated data have been published. Therefore, we conducted this meta-analysis to update and synthesize evidence on the efficacy and safety of the 2 procedures in the treatment of ureteral calculi. The relevant studies were identified by searching Medline, EMBASE and Cochrane Library Database from January 1990 to November 2015. RCTs assessing the efficacy and safety of Holmium YAG laser and PL for ureteral stones were included. Two reviewers independently screened studies and extracted data. A total of 8 studies were identified including...
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...
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.