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

Objective To evaluate the efficacy and safety of ureteropyeloscopic lithotripsy with holmium:YAG laser for treatment of ureteral calculi. Methods We retrospectively reviewed the data of 186 patients (123 males and 63 females,with an average age of 51 years) who underwent ureteropyeloscopic lithotripsy using holmium:YAG laser with a semi rigid ureteropyeloscope. Among these patients,51 had stones in the upper,64 in the middle,and 71 in the lower ureter.The stones were 0.6 to 2.5 cm (mean 1.3 cm) in diameter. Results The success rates of fragmentation in a single procedure for the upper and mid lower levels of ureteral stones were 90% (46/51) and 99% (133/135), respectively.The overall rate of successful fragmentation for all levels of ureteral stones in a single procedure achieved 96% (179/186).The mean operative time was 28 min,and the mean postoperative hospital stay was 1.2 days.No complications such as perforation occurred during the operation.In 179 patients,the postoperative follow up of 2 weeks to 3 months revealed that the stone free rate was 99% (177/179) and the hydronephrosis was markedly improved from preoperative (3.6±0.7) cm to postoperative (1.5±0.4) cm according to B ultrasound,IVU or renogram ( P 0.01).No ureteral stenosis occurred. Conclusions Ureteropyeloscopy and holmium:YAG laser lithotripsy is a highly effective and safe therapy for patients with ureteral calculi.It can be considered as a first choice of treatment,especially for those with middle or lower levels of ureteral stones.