Ureteropyeloscopy and holmium:YAG laser lithotripsy for treatment of ureteral calculi: report of 356 cases

Objective: To evaluate the efficacy and safety of holmium:YAG laser lithotripsy for the treatment of ureteral calculi. Methods: A total of 356 patients underwent ureteropyeloscopic lithotripsy using holmium:YAG laser with a semirigid uretesopyeloscope, 93 upper, 135 middle, and 128 lower ureteral stones were treated. Results: The overall successful fragmentation rate for all ureteral stones in a single session achieved 98% (349/356). The successful fragmentation rate stratified by stone location was 95% (88/93) in the upper ureter, 99% (134/135) in the mid ureter , and 99% (127/128) in the distal ureter. 12 cases with bilateral ureteral stones which caused acute renal failure and anuria were treated rapidly and effectively by the holmium:YAG laser lithotripsy. No complications such as perforation and severe trauma were encountered during the operations. 2weeks~17months (with an average of 6.8 month) follow up postoperatively revealed that the overall stone-free rate was 98% (343/349) and no ureteral stenosis was found. Conclusions: Holmium:YAG laser lithotripsy is a highly effective, minimally invasive and safe therapy for ureteral calculi. It is indicated as a first choice of treatment for patients with ureteral calculi, especially for the ones with mid-lower levels of ureteral calculi.