Trans -Ureteral Ureterolithotripsy of Ureteral Calculi: Which is the Best; Pneumatic or Holmium Laser Technique?

Introduction: Our aim was to compare two types of lithotripter including holmium: YAG laser and pneumatic one in transurethral ureterolithotripsy (TUL) for the management of ureteral calculi ≥1 cm. Methods: 112 patients with ureteral calculi more than 1 cm were selected in randomized order for pneumatic or holmium: YAG laser transurethral ureterolithotripsy (56 patients in each group). Ultrasonography and intravenous urography were performed for all patients before surgery. Complete clearance and success was defined as the absence of any fragments on post operation KUB and ultrasonography images. Results: Success rate was 85.7% in the pneumatic group and 100% in the holmium: YAG laser group (p =0.003). Stone migration up in the pelvicalyceal system was observed only in 8 cases of the pneumatic group. No statically differences were observed in terms of patients’ age, hospital stay, and complications between the two groups. Conclusion: According to our experience, for ureteral stones larger than 1 Cm treatment with ureteroscopy and laser lithotripsy is a preferring approach with favorable operation time and hospital admission, and no more significant complication.