Comparison between ureteroscopy with holmium: YAG laser lithotripsy and extracorporeal shock wave lithotripsy for lower ureter stones

Objective: To compare the safety and efficacy of ureteroscopy with holmium:YAG laser lithotripsy and extracorporeal shock wave lithotripsy(ESWL) for the lower ureter stones.Methods: 510 patients(534 sides) underwent ureteroscopy with holmium: YAG laser and ESWL.The operation time,stone-free rate and incidence rate of complications were compared between the two groups.Results: The mean operation time of ureteroscopy with holmium:YAG laser lithotripsy for stone 1 cm or greater and less than 1 cm was 50 min and 38 min,respectively,which were shorter than 67 min and 55 min with ESWL(both P0.01).The stone-free rate after 3 months in patients with 1 cm or greater stone was 98.2% for ureteroscopy with holmium: YAG laser lithotripsy.It was higher than 79.4% with ESWL(P0.01).As for stone less than 1 cm,the stone-free rate with holmium: YAG laser lithotripsy and ESWL were 100% and 95.1%,respectively(P0.05).The complication rate was 3.2%(8/250) in the group of ureteroscopy with holmium: YAG laser lithotripsy,while in ESWL group no complication occurred.Conclusions:ureteroscopy with holmium: YAG laser lithotripsy for the lower ureter stone 1 cm or greater in diameter,especially complicated with polyps or stricture,is more effective than ESWL,but no difference between the two groups for stone less than 1 cm.ESWL can be used as the first-line therapy for stone less than 1 cm in diameter.