COMPARISON OF PNEUMATIC LITHOTRIPTER AND HOLMIUM YAG LASER IN TRANSURETERAL LITHOTRIPSY (TUL)

OBJECTIVE We retrospectively compared the clinical outcomes of Lithoclast assisted lithotripsy (L group) with those of Holmium YAG laser assisted lithotripsy (H group). PATIENTS AND METHODS We analyzed records for operation time, duration of ureteral stenting, complication and stone-free rates in the L group (388 patients) and the H group (368 patients) for the primary procedure. RESULTS The stone locations (L group/H group) were U1 in 141/181, U2 in 69/57, and U3 in 178/130. Respective median stone sizes (L group/H group) were: U1,: 10.0/10.0 mm; U2,: 7.0/10.0 mm;, and U3,: 6.0/7.0 mm. Secondary procedures were performed in 79 L group patients and 35 H group patients. The median operation times (L group/H group) were 29.5/25.0 minutes. The median durations of ureteral stenting (L group/H group) were 4.0/4.0 days. The stone-free rates (L group/H group) according to the locations of the stones were 69.3/82.0% in U1, 85.5/87.0% in U2, and 92.0/98.4% in U3. Complications (L group/H group) were ureter perforation in 8/5 cases, pyelonephritis in 7/2 cases, ureteral stricture in 2/6 cases, and stone push up in 27/13 cases. CONCLUSION The operation time for holmium YAG laser assisted lithotripsy was significantly shorter than that of the Litoclast assisted procedure, and the stone-free rate with holmium YAG laser assisted lithotripsy was better than that with Lithoclast assisted lithotripsy for U1 and U3 stones.