Laser Versus Pneumatic Lithotripsy With Semi-Rigid Ureteroscope; A Comparative Randomized Study.

Area of Science:

• Urology
• Endourology
• Nephrolithiasis Management

Background:

• Ureteral stones are a common urologic condition.
• Advancements in endoscopic devices and extracorporeal shock wave lithotripsy (ESWL) have improved treatment options.
• Comparing laser lithotripsy (LL) and pneumatic lithotripsy (PL) is crucial for optimizing ureteral stone management.

Purpose of the Study:

• To compare the efficacy and outcomes of laser lithotripsy versus pneumatic lithotripsy for ureteral stone removal.
• To evaluate stone clearance rates and complication profiles between the two lithotripsy methods.
• To assess the operative time associated with each lithotripsy technique.

Main Methods:

• A randomized prospective clinical trial involving 117 adult patients with ureteral stones.
• Patients were randomized into two groups: Group 1 (58 patients) underwent Ho:YAG laser lithotripsy (LL), and Group 2 (59 patients) underwent pneumatic lithotripsy (PL) using a semi-rigid ureteroscope.
• Data on stone clearance, complications, and operative duration were collected and analyzed.

Main Results:

• No significant differences were observed in mean age, gender distribution, or mean stone size between the two groups.
• Stone clearance success rates were comparable: 79.31% for LL and 77.96% for PL (P=0.52).
• Complications were similar between groups, but operative duration was significantly shorter in the pneumatic lithotripsy group (P=0.001).

Conclusions:

• Both laser lithotripsy and pneumatic lithotripsy are effective techniques for ureteral stone management.
• Pneumatic lithotripsy demonstrated a shorter operative time in this study, possibly influenced by the surgeon's experience.
• Further investigation may be warranted to confirm the impact of operator experience on operative times in different lithotripsy techniques.