Comparison between ureteroscopy with holmium:YAG laser lithotripsy and extracorporeal shock-wave lithotripsy for ureteral calculi

Objective:To compare the safety and efficacy of ureteroscopy with holmium:YAG laser lithotripsy(LL)and extracorporeal shock-wave lithotripsy(ESWL)for ureteral calculi.Method:The data of 465 patients from January 2008 to September 2012 were analyzed.Ureteroscopy with holmium:YAG laser lithotripsies were taken in 196 patients including 104 cases with diameter of stones1.0cm and 92 cases with diameter of stones ≤1.0cm.ESWL were taken in 269 patients including 128 cases with diameter of stones1.0cm and 141cases with diameter of stones≤1.0cm.The operation time,stone-free rate and incidence rate of complications were compared between the two groups.Result:The mean operation time of LL group for stones1.0cm and≤1.0 cm were shorter than those with ESWL(both P0.01).The stone-free rate after three months in patints with stonesl.0cm was 93.3% for LL group.It was higher than 69.5% with ESWL(P0.01).For calculi≤1.0 cm,the stone-free rate with LL and ESWL were 91.3%and 89.4% respectively(P0.05).The stone-free rate after three months were 92.0% and 92.6%in the proximal and middle-distal ureteral calculi respectively without significant difference(P0.05)in LL group.While in ESWL group were 87.2% and 74.3% respectively(P 0.01).The complication rate was 4.6%in the group of LL,while in the ESWL group no complications occurred. Conclusion:All things taken into consideration,for calculi≤1.0cm in diameter especially for the proximal ureteral calculi,ESWL is worth recommending.For calculi1.0cm in diameter especially for the middle-distal ureteral calculi,ureteroscopy with holmium:YAG laser lithotripsy is the best choice.