Efficacy of holmium laser versus pneumatic lithotripsy for mid and distal ureteric stones above 10 mm size
Background: Over the past decade, ureteral stone treatment has evolved significantly. Pneumatic lithotripsy is common but prone to stone migration. Holmium laser use has increased due to fewer complications and lower stone migration rates. Aims and Objectives: The purpose of the study was to comp...
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| Format: | Article |
| Language: | English |
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Manipal College of Medical Sciences, Pokhara
2025-05-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://ajmsjournal.info/index.php/AJMS/article/view/4475 |
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| author | Arvind Arvind Sudipta Kumar Singh Partha Protim Mondal Shashi Kant Tewary Ankit Agarwal Apurv Shukla Ranjan Kumar Dey Shiva Manohar Dutta |
| author_facet | Arvind Arvind Sudipta Kumar Singh Partha Protim Mondal Shashi Kant Tewary Ankit Agarwal Apurv Shukla Ranjan Kumar Dey Shiva Manohar Dutta |
| author_sort | Arvind Arvind |
| collection | DOAJ |
| description | Background: Over the past decade, ureteral stone treatment has evolved significantly. Pneumatic lithotripsy is common but prone to stone migration. Holmium laser use has increased due to fewer complications and lower stone migration rates.
Aims and Objectives: The purpose of the study was to compare Lithoclast with holmium: YAG laser lithotripsy for mid and lower ureteral stone and evaluate the complication rate of both for the endoscopic management of ureteric stone.
Materials and Methods: This 2-year comparative study at R.G. Kar Medical College and Hospital involved 200 patients with ureteric stones ≥10 mm. Patients were randomized to groups and recorded metrics included duration, complications, and post-procedural ureteroscopic evaluations. Data were analyzed using Microsoft Excel, SPSS (v27.0), and GraphPad Prism (v5), employing two-sample and paired t-tests (significance at P≤0.05).
Results: Most participants were aged 21–50 years; the association between Hematuria in immediate post-operative period was significantly more common with Lithoclast (91%) than Laser treatment (69%) (P=0.0001). Submucosal hematoma occurred significantly more with Lithoclast (18%) than Laser treatment (2%) (P=0.0001). Ureteric perforation was significantly more common with Lithoclast than with Laser treatment (P=0.007). At 14 days postoperatively, 8% of the Lithoclast group had residual stones, while the Laser group had a 100% stone-free rate (P=0.0038).
Conclusions: This study highlights the comparative efficacy of laser and pneumatic lithotripsy for ureteric stones showing similar outcomes in demographics, stone characteristics, and operative duration. However, the laser group had a higher stone-free rate, fewer complications such as hematuria and ureteric perforation, and fewer residual stones, supporting its growing preference. |
| format | Article |
| id | doaj-art-157a97079fd54589ae2d385a2a2a8aec |
| institution | Kabale University |
| issn | 2467-9100 2091-0576 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
| record_format | Article |
| series | Asian Journal of Medical Sciences |
| spelling | doaj-art-157a97079fd54589ae2d385a2a2a8aec2025-08-20T03:52:25ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762025-05-01165115119https://doi.org/10.71152/ajms.v16i5.4475Efficacy of holmium laser versus pneumatic lithotripsy for mid and distal ureteric stones above 10 mm sizeArvind Arvind 0https://orcid.org/0009-0001-5834-9438Sudipta Kumar Singh 1https://orcid.org/0000-0002-4876-1090Partha Protim Mondal 2https://orcid.org/0000-0001-9971-6698Shashi Kant Tewary 3https://orcid.org/0000-0002-4958-7872Ankit Agarwal 4https://orcid.org/0009-0007-4979-2191Apurv Shukla 5https://orcid.org/0009-0009-6019-7726Ranjan Kumar Dey 6https://orcid.org/0000-0003-0364-4218Shiva Manohar Dutta 7https://orcid.org/0009-0009-6677-2875Postgraduate Resident, Department of Urology, R G Kar Medical College, Kolkata, West Bengal, India Assistant Professor, Department of Urology, R G Kar Medical College, Kolkata, West Bengal, India Associate Professor, Department of Urology, R G Kar Medical College, Kolkata, West Bengal, India Assistant Professor, Department of Urology, R G Kar Medical College, Kolkata, West Bengal, India Postgraduate Resident, Department of Urology, R G Kar Medical College, Kolkata, West Bengal, India Postgraduate Resident, Department of Urology, R G Kar Medical College, Kolkata, West Bengal, India Professor and Ex Head, Department of Urology, R G Kar Medical College, Kolkata, West Bengal, India Postgraduate Resident, Department of Urology, R G Kar Medical College, Kolkata, West Bengal, India Background: Over the past decade, ureteral stone treatment has evolved significantly. Pneumatic lithotripsy is common but prone to stone migration. Holmium laser use has increased due to fewer complications and lower stone migration rates. Aims and Objectives: The purpose of the study was to compare Lithoclast with holmium: YAG laser lithotripsy for mid and lower ureteral stone and evaluate the complication rate of both for the endoscopic management of ureteric stone. Materials and Methods: This 2-year comparative study at R.G. Kar Medical College and Hospital involved 200 patients with ureteric stones ≥10 mm. Patients were randomized to groups and recorded metrics included duration, complications, and post-procedural ureteroscopic evaluations. Data were analyzed using Microsoft Excel, SPSS (v27.0), and GraphPad Prism (v5), employing two-sample and paired t-tests (significance at P≤0.05). Results: Most participants were aged 21–50 years; the association between Hematuria in immediate post-operative period was significantly more common with Lithoclast (91%) than Laser treatment (69%) (P=0.0001). Submucosal hematoma occurred significantly more with Lithoclast (18%) than Laser treatment (2%) (P=0.0001). Ureteric perforation was significantly more common with Lithoclast than with Laser treatment (P=0.007). At 14 days postoperatively, 8% of the Lithoclast group had residual stones, while the Laser group had a 100% stone-free rate (P=0.0038). Conclusions: This study highlights the comparative efficacy of laser and pneumatic lithotripsy for ureteric stones showing similar outcomes in demographics, stone characteristics, and operative duration. However, the laser group had a higher stone-free rate, fewer complications such as hematuria and ureteric perforation, and fewer residual stones, supporting its growing preference.https://ajmsjournal.info/index.php/AJMS/article/view/4475holmium laser; pneumatic lithotripsy; mid and distal ureteric stones; stone fragmentation; stone-free rate; hematuria; ureteric perforation residual stones |
| spellingShingle | Arvind Arvind Sudipta Kumar Singh Partha Protim Mondal Shashi Kant Tewary Ankit Agarwal Apurv Shukla Ranjan Kumar Dey Shiva Manohar Dutta Efficacy of holmium laser versus pneumatic lithotripsy for mid and distal ureteric stones above 10 mm size Asian Journal of Medical Sciences holmium laser; pneumatic lithotripsy; mid and distal ureteric stones; stone fragmentation; stone-free rate; hematuria; ureteric perforation residual stones |
| title | Efficacy of holmium laser versus pneumatic lithotripsy for mid and distal ureteric stones above 10 mm size |
| title_full | Efficacy of holmium laser versus pneumatic lithotripsy for mid and distal ureteric stones above 10 mm size |
| title_fullStr | Efficacy of holmium laser versus pneumatic lithotripsy for mid and distal ureteric stones above 10 mm size |
| title_full_unstemmed | Efficacy of holmium laser versus pneumatic lithotripsy for mid and distal ureteric stones above 10 mm size |
| title_short | Efficacy of holmium laser versus pneumatic lithotripsy for mid and distal ureteric stones above 10 mm size |
| title_sort | efficacy of holmium laser versus pneumatic lithotripsy for mid and distal ureteric stones above 10 mm size |
| topic | holmium laser; pneumatic lithotripsy; mid and distal ureteric stones; stone fragmentation; stone-free rate; hematuria; ureteric perforation residual stones |
| url | https://ajmsjournal.info/index.php/AJMS/article/view/4475 |
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