Evaluation of Holmium YAG laser Lithotripsy in Ad-Diwaniyah Teaching Hospital


ABSTRACT:BACKGROUND:In this study we evaluate the efficacy and safety of ho:yag laser lithotripsy via rigid ureteroscopy as primary treatment modality of ureteric ston in our institute stones parameters,stone free rates and complications rates were evaluatedOBJECTIVE:To evaluate holmium YAG (yttrium aluminum garnet) laser lithotripsy via semi rigid ureteroscope in management of ureteric calculi in Ad-Diwaniyah teaching hospital.METHODS:From October 2013 to October 2014, 100 patients with ureteric calculi were included in this study. Calculi were approached with 9.5 Fr. Semi rigid ureteroscope and fragmented with holmium YAG laser system (Stone light AMS).The following parameters were assessed: success, failure, and complications rates in addition to patient’s age, sex, stone size and site. Cases of failure of introduction of the ureteroscope or those with small stones retrieved by grasper only were excluded from the study. Termination of the procedures because of perforation or retropulsion were considered as failure.RESULTS:Sixty five males and 35 females were included with a mean age of (39±3) years (range 20-60). Fifty eight patients (58%) had lower ureteric stone, 25 patients (25%) had mid ureteric stone and 17 patients (17%) had upper ureteric stone. Mean stone size was 10.61 mm (range 7-20mm).Overall success rate was 96% which was more for the lower than upper ureteric stone. Failure occurred in 4 patients (4%), 2 of them due to retropulsion and the other 2 patients due to ureteric perforation.Apart from ureteric perforation and retropulsion, complications were minor and were amenable to conservative treatment.CONCLUSION:Holmium YAG laser lithotripsy is a minimally invasive, highly effective safe method for treatment of ureteral calculi.