Evaluation of ureteroscopic pneumatic lithotripsy for ureteral stones

Objective: To evaluate success rate, auxiliary procedures and complications associated with ureteroscopic pneumatic lithotripsy of ureteric stones. Materials and Methods: The study was conducted among 100 patients between May 2011 and July 2013. The mean age of the patients was 32 ± 3 years. Ureteroscopic pneumatic lithotripsy was performed using rigid Wolf ureteroscope and Swiss Lithoclast devices. Stone diagnosis and localization was done by CT KUB without contrast. IVU was done in cases where indicated. Stone size ranged from 0.6 cm to 2.0 cm with mild to marked obstructive changes in collecting system. All patients had normal renal function test results. Results: The majority of the patients (60%) presented with lower ureter calculi, 28% with upper ureter calculi and 12% with middle ureter calculi. The patients were followed up with plain X-ray KUB and USG for two months. Stone-free status was declared as complete clearance of stone fragments from the urinary tract. The overall success rate was 96%. Auxiliary procedures conducted included balloon dilatation of ureterovesical junction (67%) and of upper ureteric stricture (1%), retrograde urography (1%), dormia basket manipulation (88%) and D-J stent placement (87%). The complications encountered were mild transient hematuria (67%), migration of stone fragments (4%), urosepsis (2%), and residual stone fragments (4%), D-J stent associated discomfort (33%) and repeat procedure (2%). Conclusion: Ureteroscopic Pneumatic Lithotripsy is an effective and safe treatment modality with unremarkable complications for ureteric stones.