Treatment of ureteric calculi - Use of Holmium: YAG Laser Lithotripsy versus Pneumatic Lithoclast. | [Journal of Pakistan Medical Association • 2007]

Author(s):

1. Salman Ahmed Tipu: Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan

2. Hammad Afzal Malik: Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan

3. Nazim Mohhayuddin: Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan

4. Gauhar Sultan: Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan

5. Altaf Hashmi: Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan

6. Syed Ali Anwar Naqvi: Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan

7. Manzoor Hussain: Department of Ophthalmology, Shaikh Zayed Postgraduate Medical Institute, Lahore, Pakistan

8. Syed Adibul Hasan Rizvi: Sindh Institute of Urology and Transplantation, Dow Medical College and Civil Hospital, Karachi, Pakistan

Abstract:

To compare the efficacy of Holmium: YAG laser and pneumatic lithoclast in treating ureteric calculi. Methods: 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 µm 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. Results: The mean patient age in LL and PL group was 38 ± 10 and 40 ± 10 years respectively. The male to female ratio and stone size were similar between the groups. Stone migration up in pelvicalyceal system occurred in two patients of LL group while in eight patients of PL group. JJ Stent was placed in 5(10%) patients in laser group where as 13(26%) patients required it in pneumatic lithoclast group. Stone free rate at 4 weeks was 92% in laser group as compared to 82% in pneumatic lithoclast group. Hospital stay was more than 24 hours in 2 patients of laser group as compared to 5 patients of pneumatic lithoclast group. Complication rate was 4% in LL group whereas it was 14% in PL group. Conclusion: Holmium: YAG laser lithotripsy is a superior technology compared to pneumatic lithoclast in terms of rate of stone clearance and complications, especially in upper ureteric stones.

Page(s): 440-443

DOI: DOI not available

Published: Journal: Journal of Pakistan Medical Association, Volume: 57, Issue: 9, Year: 2007

Keywords:

Keywords are not available for this article.

References:

References are not available for this document.

Citations

Citations are not available for this document.

Citations

Downloads

Views