LASERTRIPSY OF UPPER URINARY-TRACT CALCULI AFTER UNSUCCESSFUL EXTRACORPOREAL LITHOTRIPSY OR URETEROSCOPY - COMPARISON WITH PRIMARY LASERTRIPSY

Lasertripsy of upper urinary tract calculi after unsuccessful extracor poreal lithotripsy (SWL) or ureteroscopy (Group 1; N = 26 patients, 36 calculi) was compared with primary lasertripsy (Group 2; N = 56 patie nts, 79 calculi). Access to calculi was achieved by a Candela miniscop e or flexible ureteroscope, and laser fragmentation was performed with the Candela pulsed-dye laser. Laser alone or laser plus 1.9F basket e xtraction produced a stone-free rate of 80.6% in Group 1 and 79.8% in Group 2. Additional treatment methods were needed in similar proportio ns of both groups and in most patients consisted of SWL of fragments d isplaced into the kidney. The laser fragmentation failures rates were 2.8% in Group 1 and 7.6% in Group 2. One-month stone-free rates and ma jor complication rates were similar in the two groups. Lasertripsy aft er unsuccessful SWL or ureteroscopy was as effective as primary lasert ripsy.