Ureteroscopic Treatment of Ureteral Calculi with Holmium YAG Laser Lithotripsy.

Purpose We evaluated the effectiveness and safety of holmium YAG laser lithotripsy with a semirigid ureteroscope for ureteral calculi in a prospective cohort of 697 patients.Patients and Methods Holmium YAG laser lithotripsy was performed with a semirigid ureteroscope in 697 inpatients between September 2002 and January 2006. Calculi were located in the distal ureter in 382 patients (54.8), the midureter in 143 (20.5), and the proximal ureter in 172 (24.7). Patients were assessed 2 to 24 weeks postoperatively with repeat plain radiography, ultrasonography, intravenous urography, or some combination.Results The overall stone-free rate was 92.2, the rate being 100 for calculi in the distal ureter (N 382), 97.9 for calculi in the midureter (N 140), and 70.3 for calculi in the proximal ureter (N 121). Complications occurred in 13 patients (1.9). Postoperative ureteral stricture developed in five patients (0.72) and was managed surgically.Conclusions Holmium YAG laser lithotripsy with a semirigid ureteroscope is a highly effective and safe treatment for ureteral calculi, especially those in the distal ureter and midureter. [ABSTRACT FROM AUTHOR]