ENDOSCOPIC MANAGEMENT OF PROXIMAL URETERAL STONES: SUPERIOR EFFICACY AND REDUCED RETROPULSION WITH HOLMIUM: YAG LASER VERSUS PNEUMATIC LITHOTRIPSY
Main Article Content
Keywords
Ureteral stone, Holmium YAG laser, Pneumatic lithotripsy, Lithotripsy efficacy, Stone migration
Abstract
Proximal ureteral stones can be managed using various therapeutic approaches, with pneumatic lithotripsy (PL) and holmium YAG laser lithotripsy (LL) being the most commonly employed techniques. This study aimed to compare the efficacy and frequency of proximal stone migration between these two modalities in the endoscopic management of proximal ureteral stones.
Objective: To compare the efficacy and incidence of proximal stone migration in holmium YAG laser lithotripsy versus pneumatic lithotripsy during endoscopic treatment of proximal ureteral stones.
Materials and Methods: This study included patients undergoing endoscopic treatment for proximal ureteral stones, divided into two groups: Group A (Ho:YAG laser lithotripsy) and Group B (pneumatic lithotripsy). A semirigid ureteroscope was used in both groups. Postoperative evaluation was performed at two weeks using X-ray KUB or CT KUB (for radiolucent stones) to assess treatment efficacy. Proximal stone migration was recorded intraoperatively based on predefined criteria.
Results: A total of 88 patients (mean age: 42.1 years; range: 18–80 years) were included, with 63 males (71.6%) and 25 females (28.4%). The mean ages in Group A (41.3 years) and Group B (43.0 years) showed no significant difference (p > 0.05). The male-to-female ratio was comparable between groups (70% vs. 72%). Group A (Ho:YAG laser) demonstrated significantly higher efficacy (86.4%) compared to Group B (pneumatic lithotripsy, 81.8%) (p < 0.05). Proximal stone migration was significantly higher in Group B (9.1%) than in Group A (4.5%) (p < 0.05).
Conclusion: Holmium YAG laser lithotripsy is more effective than pneumatic lithotripsy in treating proximal ureteral stones, with a lower incidence of proximal stone migration
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Dr. Hafiz Muhammad Atif
Department of Urology and Kidney Transplant, Benazir Bhutto Hospital, Attached Medical University Rawalpindi, Pakistan
Dr. Usman Haider
Assistant Professor of Surgery, HITEC-IMS (Institute of Medical Sciences) Texila Cantt.Rawalpindi, Pakistan
Dr Shafique Ahmad
Holy Family Hospital Rawalpindi, Pakistan
Muhammad Amir Abbas
Institute of Chemistry, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
Dr. Jamaluddin Mahar
Department of Chemistry, Qaid-E-Azam University Islamabad, Pakistan
Dr. Zein El Amir
Department of Urology and Kidney Transplant, Benazir Bhutto Hospital, Attached Medical University Rawalpindi, Pakistan
