ABSTRACT
Objective: To evaluate the effectiveness and safety of treatment for proximal ureteral stones with pneumatic lithotripsy compared to holmium: yttrium-aluminum-garnet [HO: YAG] laser therapy
Study Design: Randomized control study
Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi from Sep 2014 to Mar 2015
Material and Methods: This randomized control trial was conducted at Armed Forces institute of Urology Rawalpindi. A total of 73 patients who underwent treatment between Sep 2014 and Mar 2015 were included in the study. Of the patients, 37 had pneumatic lithotripsy [PL group] and 36 had ureteroscopic HO: YAG laser lithotripsy [LL group] using rigid 8 Fr-ureteroscope for the fragmentation of the ureteric stones. Patients were evaluated for stone clearance after 3 weeks, with X-ray KUB, ultrasound and plan CT KUB [where indicated]. All the data were recorded in a proforma and analyzed in SPSS version 11
Results: There was a difference between the two groups according to overall stone clearance rate 83.8% for PL group vs. 86.5% for LL group. Proximal stone migration was seen in 16.2% of cases in PL group while in only 5.5% of cases in LL group. The overall complication rate was 35.1% in PL group while 30.5% in LL group. The mean procedure time was 28.8 +/- 4.5 minutes for PL group while it was 35.5 +/- 8.6 minutes for LL group
Conclusion: The pneumatic and holmium: yttrium-aluminum-garnet laser lithotripsy both are established choices for treatment of ureteral stone but in terms of stone clearance rate and decrease incidence of proximal stone migration HO: YAG lithotripsy is better than pneumatic lithotripsy