Comparison of the effectiveness of crushing concrements in the urinary tract with the use of holmium laser and sonotrode

INTRODUCTION Holmium lasers and ultrasound probes are widely used in urinary stone lithotripsy. The authors present a comparison of both methods in urinary stones lithotripsy. MATERIALS AND METHODS We analyzed 164-patients who underwent endoscopic lithotripsy. Ninety-eight of them (group I) were treated with the holmium laser Omni-Pulse Max 80 and were compared to the other 66-patients (group II) who were operated on with an ultrasound probe (sonotrode). Prior to the procedures, all patients were exposed to urological ultrasound and radiological imaging in order to localize the stone. The state where the stones were invisible in the radiological and renal ultrasound imaging that was performed after the operation was considered to be effective. Patients were operated under intravenous general or subepidural anesthesia. RESULTS The effectiveness of laser lithotripsy in the bladder amounted to 100% (25 of 25 patients). In the case of stones localized in the ureter it reached 89%. The total effectiveness of the procedure reached 92% (90 out of 98 procedures). In group II, the total effectiveness of the procedure reached 79% (52 out of 66 procedures). In group I, two cases the inflammatory changes of the ureter made the endoscopy impossible. These two patients were operated with open surgery. In one case, the laser lithotripsy was complicated with a perforation of the ureter. CONCLUSION The results prove that laser lithotripsy is a method of high effectiveness with a low risk of complication. It might surpass sonotrode and become its alternative. Both methods have both advantages and disadvantages.