Availability of Laser Lithotripter in Ureteroscopic Removal of Stone

Shin, Dae Yul; Lee, Young Goo

Abstract

We treated 550 ureteral calculi patients with stone basket or Candela MDL-l laser lithotripter using the rigid ureteroscope(URS) between April 1988 and November 1993. The laser lithotripsy was applied for the patients who had failed URS stone removal with stone basket. The success rates of URS stone removal with stone basket were 33.7%(120/356) in the lower ureter stones, 1.7%(2/112) in the mid, none(0/82) in the upper. The laser lithotripsy rates and success rates were 63.4%(226/356), 99.5%(225/226) in the lower ureter, 90.1%(101/112), 85.1%(86/101) in the mid, 79.2%(65/82), 80%(52/65) in the upper, respectively. The total URS stone removal success rates were 96.9%(345/356) in the lower ureter, 78.6%(88/112) in the mid, 63.4 %(52/82) in the upper. There were 65 failures due to upward migration(27 cases), approach failure to stone by URS (35 cases), no fragmentation(3 cases). Ureterolithotomy was required in 8 cases and shockwave lithotripsy in 11 cases and retry in 22 cases. The complication of URS were minimal, gross hematuria (11.2%), pain(9.5%) and infection (1.6%). Ureteral perforation occurred in only 10 patients. In conclusion, laser lithotripsy has been significantly contributed improving of success rates and expanding of applying area for URS stone removal in our series.