Comparison of Intracorporeal Pneumatic and Laser Lithotripsy for Ureteral Stones

Abstract

Background: Ureteral stones are among the most common disorders in the urologic field. Miniaturization of endoscopic devices in urology has revolutionized the management of ureteral stones. The aim of this study was to compare the efficacy and results of laser versus pneumatic lithotripsy (PL) with semi-rigid ureteroscope in a randomized prospective trial in the management of ureteral calculi.

Methods: 100 adult patients underwent ureteroscopic lithotripsy at Sher-i-Kashmir Institute of Medical Sciences. The patients were randomized into 2 groups: In group 1, 50 patients with ureteral stones underwent ureteroscopy and stone fragmentation was done by Ho: YAG laser lithotripsy (LL) and in group 2, 50 patients underwent pneumatic lithotripsy (PL) using Swiss LithoClast by using the same ureteroscope.

Results: Mean age was 37.4 years and 35.8 years in PL group and LL group respectively (P = 0.573). There was no significant difference in male to female ratio and mean stone size in both the groups. The success rate for stone clearance was 86% and 94% in group PL and LL groups respectively at one month (P = 0.317). No difference between complications was seen in both groups. Comparison of operative time showed a significant difference in operative time in favor of PL group (P= 0.007)

Conclusion: In both techniques, acceptable results were achieved. A significant statistical difference in duration of operation between our results (P = 0.007) and similar studies, while this was shorter in the pneumatic group in our study, it was longer in other similar ones. This might be a result of more experience in working with PL in our center. Further PL is a cheap yet safe and effective means of stone fragmentation.