ROLE OF LASERTRIPSY IN THE MANAGEMENT OF URETERAL CALCULI - EXPERIENCE WITH ALEXANDRITE LASER SYSTEM IN 232 PATIENTS

In 232 patients with ureteral stones, lasertripsy was used as primary treatment or as second-line therapy after extracorporeal shockwave lit hotripsy (SWL), In all patients, a semirigid 6.5F ureteroscope or a fl exible 6F ureteroscope was used, Lithotripsy was performed employing a n alexandrite laser with an energy of 50 to 65 mJ, The immediate succe ss rate was 67.5 % for stones in the upper ureter, 86.1 % for those in the midureter, and 94.5 % for those in the distal ureter, In 16.5 % o f the treatments, it was necessary to insert a double-J stent, A perfo ration of the ureter happened in two patients (0.9 %), but no laser-re lated complications were seen, Stone fragmentation was not dependent o n stone composition or size, Using small semirigid or flexible uretero scopes, lasertripsy of ureteral stones is a minimally invasive treatme nt with an insignificant complication rate, In cases of midureteral st ones, our results revealed a higher immediate stone-free rate than is reported in the literature after treatment by SWL, and we can therefor e recommend lasertripsy as primary treatment, For upper ureteral stone s, lasertripsy can be recommended as a helpful auxiliary procedure, Fu rthermore, in cases of distal ureteral stones, lasertripsy challenges SWL as the primary treatment.