SAFETY AND EFFECTIVENESS OF HOLMIUM-YAG LASER VERSUS PNEUMATIC LITHOTRIPTER IN THE MANAGEMENT OF URETERAL STONES

Abstract

Background: This study aimed to compare effectiveness and safety of laser and pneumaticlithotripsy in the management of ureteral stones.Methods: From October 2014 to March 2016, 75 patients with single unilateral impactedureteral stone of any size were selected. The patients were randomized into two groupsaccording to the lithotripter used to fragment the stone: Laser (n = 40) and pneumatic (n = 35).-operative follow-up findings wereanalyzed and compared.Results: The overall rate of stone clearance in laser group was 92.5 % (n = 37) compared toonly 85.7% (n = 30) of the patients in the pneumatic group (p = 0.038). The mean operationtime among patients in the laser group was 36.7 minutes (SD = 9.7) compared to 30.2 minutes(SD = 7.0) in the pneumatic group (p = 0.002). Most common post-operative complications inlaser group included stone migration (n = 3), perforation (n = 1), and post- operative fever (n =1) compared to migration (n = 1), post-operative fever (n = 3), and ureteric stricture (n = 1) inpneumatic group. Approximately an equal number of patients in both groups required JJ stentinsertion at some point (n = 20).Conclusion: Higher rates of stone clearance and lesser complications were noted amongpatients treated with YAG laser lithotripsy, indicating its superiority over pneumatic lithotripsyin the management of ureteral stone.