Comparison of Fragmentation and Dusting Modality Using Holmium YAG Laser during Ureteroscopy for the Treatment of Ureteral Stone: A Single-Center’s Experience

Laser ureteroscopic lithotripsy (URSL) is an efficacious treatment for ureteral stones. There have been few previous studies comparing the different energy and frequency settings for URSL in a single center. We compared these two laser modalities, which were simultaneously used in our medical center for the treatment of ureteral stones. Patients who underwent fragmentation or dusting laser URSL between September 2018 and June 2020 were retrospectively reviewed. We compared patients who underwent fragmentation and dusting laser and assessed the enhancing factors for stone free rate. There were a total of 421 patients with ureteral stones who met the study criteria. There was no significant difference between the characteristics of both groups. The fragmentation group had a better stone free rate and a lower retropulsion rate compared with the dusting group. Multivariate analysis revealed that stone basket use, no upper ureteral stone or pyuria significantly improved the stone free rate. Both laser modes were effective and safe for ureteral lithotripsy although the fragmentation system showed slightly higher effectiveness and lower complication rate.