Pneumatic lithotripsy versus holmium: yag laser lithotripsy as treatment of urologic stone disease



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tarix02.03.2018
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Pneumatic Lithotripsy versus Holmium:Yag Laser lithotripsy as treatment of urologic stone disease
S. Cimino1,G. Russo2 ,T. Castelli2, M. Madonia3, A. Saita2, F. Marchese2, V. Favilla2, E. Fragalà2, M. Russo2, G. Morgia2
1 Department of Urology, Polyclinic Hospital, University of Messina, Messina, Italy

2 Department of Urology, Polyclinic Hospital, University of Catania, Catania, Italy

3 Department of Urology, Polyclinic Hospital, University of Sassari, Sassari, Italy


Objective: A comparative study to analyze the stone-free rates between Pneumatic lithotripsy(PL) and Holmium laser lithotripsy(LL) as treatment of urinary lithiasis.

Materials and methods: From January 2010 to January 2011, 149 patients with 211 urinary stones underwent to Retrograde intrarenal lithotripsy(RIRL) or Ureteroscopy with Pneumatic lithotripsy(PL) or Holmium:YAG laser lithotripsy(LL). One-hundred-twelve stones were treated with Holmium:YAG laser lithotripsy (LL group) and 99 stones with pneumatic lithotripsy(PL group). The stone-free rates in both groups were compared.

Results: Mean age in the LL group was 48 years, while in the PL group was 51. In our analysis, stone size average was 13.1 mm in the PL group and 13.8 mm in the LL group. In the LL group, 34 stones had a size more than 10 mm and 78 had a size less or equal to 10 mm. In the PL group, 35 stones had a size more than 10 mm and 64 had a size less or equal to 10 mm. Ureteral Stone-free rate in the PL group was 80.7% and 86.1 % in the LL group (p=0.002), while renal Stone-free rate in the PL group was 92 % and 87.8 % in the LL group (p=0.32). In our comparison, stone free-rate for cumulative stones was higher in the LL group than in the PL group (p=0.001; Pearson χ2-test) after 3 months, without any retreatment.

Discussion: URS and RIRL occupy an essential place as mini-invasive techniques and their use is associated with a success rates of 80% to 95% reported.

The stone-free rate for renal stones has been reported in 90-92 % of patients treated with Ho:YAG laser lithotripsy and successful fragmentation of ureteral stones of all compositions has been reported in 91% to 100% of cases, with a mean stone-free rate of 95%.



Our study demonstrated a significant higher stone-free rate in the group treated with the Ho:YAG laser than in the group treated with Pneumatic Lithotripsy. Complicances were not severe and RIRL or URS were well tolerated by the patients.
Conclusions: Holmium:YAG laser lithotripsy is associated with a higher stone free rate than Pneumatic lithotripsy for urinary lithiasis treatment.
Keywords: Pneumatic lithotripsy, Holmium:YAG laser lithotripsy, urinary lithiasis.
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