Comparison of laser and pneumatic lithotripters used in the ureterorenoscopi̇c treatment of proximal ureter stones

Aim: Studying efficiencies and reliability of ureteroscopic laser lithotripsy and pneumatic lithotripsy methods for patients with proximal ureteral stones. Materials and methods: Files of 244 patients with history of laser lithotripsy and pneumatic lithotripsy treatments (LL: 139, PL 105) due to ureteral stone at out clinic between October 1 2013 and October 1 2018. The results are assessed in correlation with plain urinary system X-Ray, urinary ultrasound, non-contrast enhanced computerized tomography or intravenous urography scans, which were performed one day and one month after the treatment. Durations of surgeries, hospitalization durations, rate of acalculous state and rate of complications arising from ureteroscopic laser lithotripsy and pneumatic lithotripsy methods. Results: Total 244 patients; 139 from laser lithotripsy group and 105 from pneumatic lithotripsy, were included in the study. 101 male patients (72.6%) and 38 female patients (27.42%) were included in the laser lithotripsy group; while 79 male patients (75.2%) and 26 female patients (24.8%) female patients were included in the pneumotic lithotomy group. Average age of the patients in the laser lithotripsy groups was 44.47± 15.702 years while the average of the patients in the pneumatic lithotripsy group was 41.24± 3.723. Average stone size in laser lithoptripsy was 11.26±3,752 mm; while average stone size in pneumatic lithotripsy group was 10.98± 4,572 mm. distribution of stones to sides in laser lithotrpsy group was 57.6% at right side and 42.4% at left side; while the distribution in pneumatic lithotripsy was 43.8% at right side and 56.2% at left side. Rate of major complications are 6.4% and 9.4%, respectively (P >0,05). Acalcolous state in postoperative month one in laser lithotripsy group was 87.1%; while it was 81% in pneumatic lithotripsy group (P >0,05). Duration of postoperative hospitalization in laser lithotripsy group was 17.12±4,511 hours; while in pneumatic lithotripsy group it was 25.26±29,657 hours (P <0.05). Surgery durations in laser lithotripsy group was 41.29±12,119 hours; while in pneumatic lithotripsy group it was 36.10±12,972 minutes (P <0.05). Conclusion: Both lithotripsy methods may be used efficiently and safely due to high rate pf acalcolous state and low complication rates in treatment of proximal ureteral stone.