TREATMENT OF URETERAL STONES - COMPARISON OF LASER AND PNEUMATIC LITHOTRIPSY

Objectives To study the treatment of ureteric stones by laser lithotri psy (LL) and pneumatic lithotripsy (PL), and to evaluate the results o f the two treatment modalities to assess effectiveness, complications and cost benefits. Patients and methods Between January 1993 and Febru ary 1994 200 ureteric stones in 194 patients were fragmented intracorp oreally, 48 by LL and 152 by PL. The ages of the patients ranged from 31 to 40 years with a male to female ratio of 2 : 1. All procedures we re performed under general/regional anaesthetic in a day-care set-up. Patients were followed at weekly intervals. Re-treatment was carried o ut at 4 weeks where necessary. Results The majority of the stones trea ted (84%) were in the lower third of the ureter, 69% measured 7-12 mm in diameter, and 61% were composed of calcium oxalate. Ninety-three pe r cent of the stones were fragmented in one treatment session. The ove rall stone-free status at 4 weeks was 95% for PL and 84% for LL. The n on-fragmentation rate was 10% for LL and 1% for PL. Post-treatment com plications were encountered in 8% of the patients treated by LL and 7% by PL. Conclusions Our experience shows that PL and LL both provide a safe and effective means of performing intracorporeal lithotripsy for smaller ureteric stones, However, PL is more effective in fragmenting larger and harder stones. Moreover, PL is more user-friendly and high ly cost-effective compared with LL.