ABSTRACT
Objective To investigate the treatment effect of retrograde holmium laser lithotripsy on treatment of impacted ureteral calculi.Methods One hundred and twenty-eight patients with ureteral calculi in the Second Affiliated Hospital of Xinjiang Medical University from Feb.2011 to Dec.2013 were divided into unimpacted ureteral calculi group (70 cases) and impacted ureteral calculi (58case).The treatment efficacy,operation complications of holmium laser lithotripsy and the causes of the failure of operation were recorded.Results The stone clearance rate,operative periods and postoperative incidence of gross hematuria in the un-impaction group were 91.4％ (64/70),(36.3 ± 10.7) min and 51.4％ (36/70) respectively,significant different from those in impacted ureteral calculi(74.1％ (43/58),(45.2 ± 13.9) min and 84.5％ (49/58) respectively;x2 =6.914,t =3.736,x2 =15.535 ;P ＜ 0.05).There were no significant difference between the un-impaction group and impaction group in terms of the postoperative hospital stay periods,analgesics utilization rate,urinary tract infection rates and ureteral perforation rate.In the un-impaction group,6 cases were surgical failure due to the movement of ureteral calculi during the operation.Fifteen cases were surgical failure in the impaction group,mainly due to the stone fragments move,the ureter excessive distortion and ureteral stricture.The success rate was 58.3％ (14/24) of the stones,which were above the level of L4 in the impaction group,while the success rate was 85.3％ (29/34) of the stones that was below the level of L4 in the impaction group (x2 =5.334,P ＜ 0.05).Conclusion Impacted ureteral calculi is more difficult to deal than unimpacted stone.The operation success rate of impacted stones above the level of L4 is less than below L4 due to stone fragments and ureter distorting.