PNEUMATIC LITHOTRIPSY VERSUS HOLMIUM LASER IN MANAGEMENT OF DISTAL URETERAL CALCULI (A PROSPECTIVE RANDOMIZED STUDY)
Ahmad M. EL-Sadat1, Ayman M. Edrees2, Khaled M. Sabry2
1Urology Department, Air Force Hospital, Cairo, Egypt.
2Urology Department, Faculty of medicine for Girls, Al-Azhar University, Cairo, Egypt.
Objective: The aim of this research was to evaluate the effect of holmium laser versus pneumatic lithotripsy in the management of distal ureteric calculi. Patients& Methods: this study was carried out on 40 patients above 18 years old at AL-Zahraa University Hospital and Air Force Hospital from January 2016 to April 2017. Inclusion criteria included a lower ureteral stone with stone size from 8mm to 2cm and failed medical treatment for two weeks. Exclusion criteria included pregnancy, bleeding tendency, surgically unfit, congenital renal anomalies, bilateral, and recurrent ureteral stones. Patients were classified into: Group I: 20 patients underwent pneumatic lithotripsy, and group II: 20 patients underwent a Holmium lithotripsy technique. The demographic data of the patients were enrolled and analyzed. Postoperatively plain x- ray &CT (abdomen& pelvis) was done to evaluate stone-free rate for radiopaque and radiolucent stones respectively. Follow-up was done after one month by CTUT or IVU to determine stone-free rate, ureteral stricture or any other complications. Results: forty patients presented with distal ureteric calculi enrolled in this study. 15(75.0%) cases were males and 5(25.0%) cases were females with a mean age of 42.7 ± 11.89 years in (Group I) & 16(80.0%) cases were males and 4(20.0%) cases were females with a mean age of 42.25 ± 9.25 years in (Group II) with no statistically significant difference (table1).The stone free rate in first group was 95% & 100% in second group (p value=0.311). Conclusion: our research revealed that holmium laser had powerful disintegration rate in distal ureteric calculi than pneumatic lithotripsy, with fewer complications.