The Comparison of Treatment Results of Ureteroscopic Lithotripsy with Lithoclast and Electrohydraulic Lithotripsy

Jeon, Seung Hyun; Lee, Sun Ju; Lee, Choong Hyun; Chang, Sung Goo; Kim, Jin Il

Abstract

PURPOSE: Four techniques of intracorporeal lithotripsy are now available: ultrasonic, electrohydraulic, laser and Lithoclast. Among these methods, we studied retrospectively the efficacy and safety of Lithoclast and electrohydraulic lithotripsy(EHL) in the treatment of ureteral stones.
MATERIALS AND METHODS
From May 1994 to October 1997, a total of 70 cases with ureteral stones were randomized to either method(39 to Lithoclast and 31 to electrohydraulic lithotripsy).
RESULTS
Overall success rates were 84.6%(33 cases among 39cases) for Lithoclast and 83.9%(26 cases among 31 cases) for EHL, so both methods are equivalent in efficacy. The success rates according to location were 85.7% in proximal ureter, 82.4% in middle ureter, 86.7% in distal ureter for Lithoclast and 78.6%, 90.0%, 85.7% for EHL. The success rates according to size were 90.0% in<5mm, 83.3% in 5-9mm, 80.0% in > or =10mm for Lithoclast and 100%, 77.8%, 90.0% for EHL respectively. There were 6 failures with Lithoclast due to upward migration of stone. There were 5 failures with EHL due to upward migration(3 cases), extremely hard consistency(1 case) and poor visual field(1 case). Complications of ureteroscopic stone removal were fever(1 case), ureteral perforation(1 case) with Lithoclast and hematuria(1 case) with EHL, which were treated conservatively.
CONCLUSIONS
We have found that efficacy and safety of EHL is as satisfactory as Lithoclast in skilled hands.