Background: Among various intracorporeal
lithotripters, pneumatic lithotripter has become the widely used tool for the
treatment of urinary stones. Recently the holmium: YAG laser has been used with
a wide range of potential urological applications, including intracorporeal
lithotripsy of urinary calculi. Purpose: Compare the effectiveness and
complications of treatment for ureteric stones between holmium laser
lithotripsy and pneumatic lithotripsy. Material and Methods: Comparison of 100
patients presented with ureteric stones, group one (50) of whom were treated
with pneumatic lithotripsy and group two (50) with holmium laser was done and
the effectiveness and complications of both were analyzed. Results: There was
no difference in patient age, sex, stone size and location of stones between
the two groups. The immediate stone free rates were 88% in the holmium: YAG
group and 66% in the pneumatic lithotripsy group (p < 0.05). The four weeks
stone free rates were 98% and 94% respectively (p = 0.07). The mean ± SD
operative time in the holmium: YAG group (40 ± 26 min) was shorter than those
with pneumatic lithotripsy group (60 ± 40 min). Postoperative stay in hospital
was less than 24 hours in holmium: YAG group (70.4%) and shorter than those for
pneumatic group (29.6%) (p < 0.002). Post treatment complications such as
ureteral perforation were encountered in only two patients who underwent
pneumatic lithotripsy. Other complications, such as mucosal injury, ureteral
perforation and postoperative fever; there was no statistically significant
difference between the two groups. While light hematuria was found more
frequently in the pneumatic group (14%) in comparison to laser group (12%) (p =
0.02). On the other hand, the overall complication rates between the two groups
was statistically significant (8%) laser group vs. (32%) pneumatic group (p =
0.003). Conclusions: Holmium: YAG laser lithotripsy was associated with shorter
operation time and postoperative hospitalization period. These data suggest
that holmium: YAG lithotripsy was safe and more effective than Pneumatic
lithotripsy in the aspect of immediate stone free rate. We believe that
holmium: YAG is an excellent treatment modality for managing ureteral calculi.
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